As a psychiatrist, every day I encounter families struggling with mental illness, especially in their children whose lives range from disrupted to shattered as a consequence of these challenges. In these daily battles I’m most frustrated and saddened by the jaw-dropping lack of compassion surrounding me and my patients regarding their family struggles and their child’s distress.
Unfortunately, many people still view mental illness as a moral rather than a medical or developmental issue. As a result, they readily dispense judgment when someone is struggling with emotional and behavioral symptoms – shutting down open discussion and squashing attempts to problem solve rather than blame.
Even worse, stigma and misunderstanding paralyze many people who might consider seeking help but don’t because they’re afraid of being judged or feel somehow to blame. Families are told they’re being manipulated by their loved one who’s suffering or that their parenting is impaired. Just “try harder” says the teacher, the coach, the neighbor, and the in-laws.
Usually, nobody’s trying to hurt anyone. In fact, they’re trying to help, but sadly, with such poor public understanding of mental health and mental illness, harmful information and recommendations are much more common than scientifically based, nuanced ideas.
One of the root problems is that mental health tends to be invisible, and we don’t trust what we can’t see, especially when it comes to the science of the mind. But I think that science and medicine are the two best weapons we have in fighting the stigma. Yes, we have no lab test for bipolar disorder or a host of other mental illnesses and brain or behavioral disorders, but we do have plenty of scientific and medical evidence to prove a biological basis for these illnesses and disorders:
- Neuroimaging evidence that shows distinct differences in brain activity of those with a specific brain disorder versus those without
- Heredity data showing that bipolar disorder and other mental illnesses tend to run in families
- Neuroimaging studies showing brain changes that are inherited for up to two generations
- Genetic studies that link bipolar and other psychiatric conditions to gene mutations
- Animal models that mimic certain psychiatric symptoms and research studies relating particular brain circuits to patterns of behaviors and responses to the environment in these animals
- Suggestions of infections being related to certain conditions such as antibodies to strep possibly triggering Obsessive Compulsive symptoms
Most people have no trouble recognizing that autism or epilepsy are biologically based brain disorders. They also have no problem admitting that brain trauma can cause a person to experience behavioral changes. But tell these same people that you have bipolar disorder or depression, and they’re likely to tell you to, “Get over it!” “Be strong!” or “Everyone’s got problems!” They just can’t clear the hurdle of realizing that the brain can get ill and that the illness can result in significant thought and behavioral changes.
The possibility of not being in full control of how we think and act is actually quite frightening to most of us – we want to believe that we’re fully in charge. The idea that something unseen and unknown can hijack our brains and make us feel and behave in ways we can’t control is simply unbearable to many people.
Until we can accept this idea that our thoughts and behaviors are biologically rooted – and not fully under our control, even without mental illness – we’ll be unable to fully embrace the notion of mental illness as something that happens to a person, rather than something they choose.
Photo by Ian T. McFarland, available under a Creative Commons attribution license.