Another school year is coming to an close. We can all recall feeling trapped in the classroom at year's end, dying to be set free as the teacher drones on about something we detest. Swallowing the pill of an unwanted lesson is what it feels like to people with mental illness when they're labeled and treated as abnormal, different, or maybe even deficient.
Although the current environment of "privacy" has its merits, sooner or later the truth comes out. People know you’re not sitting in a therapist’s waiting room because of hemorrhoids. So whether you out yourself or not, labeling occurs. It starts subtly, then seems to take on a life of its own. All kidding aside, this burden can be unbearable at times, and has implications and consequences that become life-changing, frequently in a negative way.
Things happen when you’re diagnosed with a mental illness and the label is applied — sometimes you think you can almost feel it on your forehead. Perhaps your complaints won’t be taken seriously because you’re “crazy”; you won’t be considered for the promotion or may, in fact, find your job in jeopardy; you may not be able to get insurance or even buy a home in a certain neighborhood, etc. You begin attempts to scrub the label off.
You “forget” to tell the surgeon that you’re on a mood stabilizer or sleeping pills, you make your therapy appointments after work hours, you don’t list your diagnosis on forms about your medical history. You’re in constant fear of detection, and this makes the work at managing your illness that much harder. You begin to understand what gays and lesbians deal with in the military, for example, or in day-to-day society. You know you don’t “deserve” this kind of treatment, but you don’t know how to stop it. You get tired just thinking about it.
The consequences of labeling often prevent people from seeking help in the first place. This and other factors (such as lack of health insurance or inadequate coverage for mental illness) only result in an acceleration of the mental illness epidemic.
What epidemic? Here are the facts. Global and regional statistics on illness are compiled by the and can be found in summaries such as the Global Burden of Disease. This report summarizes years lost to disability, a measure of years of healthy life lost through time spent in states of less than full health. Globally, neuropsychiatric disorders account for one-third of YLD in adults over the age of 15.
Unipolar depression tops the list in high-income countries, surpassing alcohol use, diabetes, and COPD. Cancer and heart disease don't even make the top ten! When viewed as a disability-adjusted life year or DALY (1 DALY = 1 lost year of healthy life), depression ranks third as a global cause of disease burden, and is projected to take the top spot by 2030. More productive years will be lost by depression than by heart disease, AIDS/HIV, prematurity, cancer, etc. How can this be?
What is going on here? Are you as astounded by this statistic as I was when I first unearthed it?
We are often reminded to treat ill persons with empathy, which is defined by the Oxford English Dictionary as “the ability to understand and share the feelings of another.” While we speak of the need for compassion as well, it is interesting that this is defined as “sympathetic pity and concern for the sufferings and misfortunes of others.”
I don’t want to split hairs here, but as a person with depression for more than 20 years (who also happens to love words), I can unequivocally state that the mentally ill almost always spurn this concept. We all want compassion, yes, but we don’t want people to pity us.
And yet the very word is incorporated in compassion’s definition. Pity, then, is defined as “the feeling of sorrow and compassion caused by the sufferings and misfortunes of others.” So we’ve come full circle! Compassion, pity, empathy — what's the bottom line? The elements of these definitions that jump out at me are: feelings, share, understand, sufferings, misfortunes.
It strikes me that these come into play almost unconsciously when we discover someone has, for example, cancer or a heart attack. We instantly feel their suffering, know they are unfortunate, and may even share in their experience by something simple like sending flowers or cards. What if we applied these same concepts to dealing with mental illness, substance abuse, or other mind disorders? What a wonderful world it would be.
Diagnosing a mental illness provides a framework — for both patient and health professionals — in which to move forward to a healthier state, a condition where one can once again be productive and self-sufficient, where loss from disability is minimal or even absent.
If that’s what the label can accomplish, of course it's a good thing. But when the label causes discrimination and prejudice, mistrust and misunderstanding, everybody loses. Can we slow down or reverse the epidemic? If we sharpen our focus on sharing and understanding our sufferings and misfortunes, we've can take a huge first step.
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