Archives for Stigma
Bipolar disorder—mental illness in general—has not fared well in popular culture. "Crazy" patients and "crazier" doctors populate story lines based on stereotypes and stigma. The last few years have seen some evolution toward more realistic portrayals and narratives, including the movie Silver Linings Playbook and the Broadway musical Next to Normal, telling human stories of illness rather than just punchlines. Add to this burgeoning cannon a new Netflix comedy, Lady Dynamite, by the comedian Maria Bamford.
May is Mental Health Awareness month, and today is Child Mental Health Awareness Day. Our goal, as healthcare providers, family members, and people living with mental illness, is to spotlight the presence of mental illness in our communities and to spread the word that these are identifiable and treatable medical and neurodevelopmental conditions which are not cause for shame.
My wife, Cecie, has bipolar disorder. Recently, she got into some trouble at work over a policy she violated. Not that it's anyone's business, but I'd better explain what she did (with her permission, of course), so you don't imagine something worse than it is. Cecie is a teacher. She brought her new puppy to school for a couple days and had two (high school) students take it outside the school building (located in a very safe area) without signing out. She received a written reprimand over the incident, which I personally think was a little over the top, but so be it.
Sandra lives with bipolar disorder. I am her psychiatrist or p-doc or shrink (as in Dr. Fink, the shrink). Sandra (not her real name), and I have worked together for many years. At today's appointment, she is moving a little slowly due to some back pain, but she tells me that her mood and energy have remained steady. That is outstanding news, because until a couple of months ago she was experiencing a terrible mood episode that rocked her life—a difficult mixed episode (mania and depression), along with substance use and memory and thinking problems. Her symptoms disrupted relationships with her family and worsened existing financial troubles. But, fortunately, her mood and energy level have not wavered to any clinically significant degree. Today she smiles and tells me about her volunteer work and playing tennis with a friend. Then she stops, and she cries softly and asks me how to help her parents understand what is wrong with her. While the good news is that many people in Sandra's life are starting to grasp that bipolar disorder is the problem (and that Sandra is not the problem), her own family of origin shuns and shames her, telling her that they have been advised to "stop enabling" her "bad behavior." They will not let her come to stay with them, and she has been excluded from family events. Sandra is heartbroken.
The American Heart Association has released a statement (circ.ahajournals.org/content/early/2015/08/10/CIR.0000000000000229.abstract) identifying major depressive disorder and bipolar disorder in adolescents as specific risk factors for the early development of cardiovascular disease. Their review of numerous studies shows consistently higher risks of cardiovascular disease in adolescents with mood disorders compared to those without. Increased rates of heart disease in adults with depression and bipolar disorder have been well documented, but this is the first full examination of the data in young people with mood disorders.
I just watched President Obama's "Shameful Day for Washington" speech, and I take issue with the fact that he included people with severe mental illness in a group he described as "dangerous individuals." Here's what he said: "By now it's well known that 90 percent of the American people support universal background checks that make it harder for a dangerous person to buy a gun. We're talking about convicted felons, people convicted of domestic violence, people with a severe mental illness."
"We have no national database of these lunatics... We have a completely cracked mentally ill system that has these monsters walking the streets." — Wayne LaPierre, Executive Vice President NRA Since the tragedy at Sandy Hook Elementary School in Newtown, Connecticut there have been pages and pages written and hours of audio and video created by people from all sides of the gun control/gun safety discussion. The conversation about the need for better mental health awareness and care, especially for children, is welcome. Comments like Mr. LaPierre's are not.
Yesterday, I served on a panel of family members who have loved ones with mental illness, where we talked to a room full of police officers (approximately 30 of them) as part of their crisis intervention team (CIT) training. NAMI-WCI (West Central Indiana) provided the training. As I prepared my story for the presentation, I realized that I am never the one who calls 911 when my wife is experiencing a manic episode. My wife has always been the one to call, usually because she is experiencing paranoia and psychosis and feels the need to call the police for protection. This made me wonder... why?
The Fall edition of the NAMI Advocate (2012) contains an interesting article by NAMI Communications Coordinator Brendan McLean entitled "The Hope for Mental Illness Research: Dr. Tom Insel Shares the Latest Data at NAMI Convention." But it wasn't the discussion about research that piqued my interest. Instead, it was what Dr. Insel said about stigma and the importance of engaging the family in the recovery process.
Stigma Versus Discrimination
Last Thursday, my wife and I attended a viewing of Dr. Delaney Ruston's documentary film Unlisted followed by a panel discussion. The film and panel discussion focused primarily on schizophrenia, but individuals with bipolar disorder and their families face similar struggles. I was very impressed by the keynote speaker, Dr. Alan Breier, MD, who passionately and compassionately described the struggles of people living with schizophrenia. He called schizophrenia the "quintessential human experience," because it affects the two qualities most responsible for making a person feel human: The ability to work The ability to love