Going to therapy or talking with friends or family about things like anxiety, depression or PTSD, was once considered taboo. But, mental health has increasingly become a more widely accepted topic of discussion. In 2018, the American Psychological Association found that 87% of American adults agreed that having a mental health disorder is nothing to be ashamed of. They also found that 86% said they believe that people with mental health disorders can get better.
While people are becoming more open about mental health, there are many things that people still aren’t talking about. Like the fact that 33% of Americans didn’t consider anxiety as a mental health disorder and 22% said the same about depression. Another 39% of people said they would view people differently if they knew that person had a mental health disorder.
Based on findings, the stigma of mental illness is still a prevalent issue. Stigma happens when one person views another as different or “other”. People who are placed under a stigma are often denied full social acceptance, viewed as having negative attributes, and tainted or discounted.
What To Know About Mental Illness?
Talking about mental illness means going beyond the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V) definitions, stereotypes, and statistics. Here are some things about mental illnesses that most people don’t talk about.
1. Mental Illness is Not What the Media Portrays
The media, including television, films, magazines, and social media, often portrays mental illness as stereotypical, negative or simply wrong. This allows people to have an inaccurate view of those with psychological disorders when they watch a movie or read a caption on social media.
People with mental illness are often depicted as crazy, dangerous, incompetent, and disheveled in the media. These appearances serve to distance those who are open about their mental illness from “everyone else”. For example, people with depression are often portrayed as hysterically crying while isolated in a room, spending more time in the dark, and highly suicidal. Yet new studies show that the risk of death by suicide is largely related to severity of depression and that only about 2% of those treated for depression in an outpatient setting will die by suicide.
Studies show that individuals with mental illness are less likely to commit violent crimes and are actually more likely to be victimized. People with mental illness aren’t “crazy” or violent like the media may portray them as, even if they may look it due to disheveled hair or dirty clothing. While some people with mental illness do struggle with hygiene practices, there are many who wake up, shower, and resume their responsibilities every day.
The media does little to differentiate between the types of mental illness and loops every disorder into one bucket. There’s a substantial difference between psychosis, where one experiences hallucinations and delusions, and anxiety, where someone feels a heightened level of fear and worry. Research found that about 12% of the characters found on T.V suffered from some form of psychosis, like schizophrenia, but only affects about 1% of U.S adults.
Whether someone suffers from bipolar disorder, depression, or dissociative identity disorder, mental illness shows up differently in real life for everyone. There is no one-size-fits-all when it comes to mental illness.
2. How Debilitating Mental Illness Is
Symptoms of mental illness can be so severe that they impact normal, day-to-day functioning. Depending on the severity of the illness, simple and everyday activities can be difficult. Some signs of mental illness have become debilitating include:
- Not showering or bathing for days or weeks
- Neglecting hygiene, wearing dirty clothes, and not brushing hair
- Not eating or only eating junk food
- Being unable to function at school or work
- Noticeable slowness in the ability to think or basic activity, like walking around the house
- Psychotic symptoms like delusions or hallucinations
When mental illness becomes debilitating, it can cause serious complications like self-harm or loss of a job. It also increases the risk of comorbidities. A recent study of nearly 6 million people analyzed 83.9 million person-years of data and found that those who were diagnosed with one mental illness had a 2 to 48-fold increased risk of a diagnosis of a second mental health disorder.
3. The Burden Mental Illness Carries
Living with a mental illness comes with its own set of complicated feelings, including guilt and shame. Guilt and shame are often interchanged, but they have very different meanings. Guilt means “I did something bad or wrong”, whereas shame means “I am bad or wrong”. Both are normal feelings and aren’t always negative. Some feelings of guilt or shame help develop a sense of morals and can shape positive behavior. But when these emotions become overwhelming, they can cause mental health issues.
A 2013 meta-analysis found that major depressive disorder (MDD) is associated with self-blaming emotions, like guilt and shame. People who have feelings of chronic guilt or shame are at a higher risk for mental illness, like depression or anxiety. Likewise, people who have a mental illness can carry these feelings because of their mental state or related behavior.
A 2017 study found that self-stigma leads to negative effects on recovery for people diagnosed with mental illness. These negative effects include:
- Reduced hope
- Lower self-esteem
- Increased symptoms
- Trouble with relationships
- Reduced likelihood of staying in treatment
- More difficulty at work
The negative cycle of mental illness stigma makes it more difficult for people to function in their daily lives and makes the illness worse.
4. The Physical Toll of Being Mentally Ill
Mental illness isn’t “all in your head”. It does affect your brain, but it also affects the rest of your body. People with mental illness can experience physical symptoms like:
- Muscle tension
- Digestive issues like stomach pain or diarrhea
- Changes in weight
Physical symptoms caused or made worse by mental illness are called psychosomatic. While the exact connection between the two isn’t clear, researchers know that stress and depression can both manifest as physical pain and illness.
5. There Are No “Breaks”
When you have a mental illness, it means dealing with it 24 hours a day 7 days a week. There are no breaks, no off switch to mental illness. People who have a mental illness, and those who love them, are constantly working through lows or arranging their lives to minimize the likelihood of another one.
Many people describe their mental illness as a full-time job. Depending on the type and severity of mental illness, It can require a significant amount of additional support just to feel “normal”. This may mean going to multiple doctors every week, going to support groups, or following a specific diet. Even then, many still feel the weight of the illness.
6. Discrimination and Abuse Towards the Mentally Ill
People with mental illness should have the same access to the same opportunities as people without mental illness. While laws exist to enforce those rights, many people with mental illness still face discrimination and unfair practices like unemployment, inadequate housing, and high rates of incarceration.
Employment is an important factor for sustaining mental health recovery. One meta-analysis found that people with mental illness were unemployed or underemployed (less working hours) at significantly higher levels compared to the general population. This is because they were perceived as incompetent and less promotable. In addition, people with mental illness often receive lower wages and have less access to quality jobs.
Mental illness or not, everyone needs adequate housing to live a healthy life. Having a safe, clean space to live is a critical part of recovery that unfortunately, many people with mental health issues don’t have access to. Despite protection, people with mental illness still face discrimination when searching for housing.
If you feel you have been a victim of employment or housing discrimination, there are steps you can take to rectify the situation. You can file a complaint with the Fair Employment Practice Agency or the Fair Housing Act.
In addition to unequal housing and employment opportunities, people with mental illness are more likely to be incarcerated or have longer sentences compared to the general population. Studies found that after being sent to jail, people with a mental health disorder stay 2-3 times longer in pretrial and face longer sentences. They are also less likely to get parole, will cycle through the criminal justice system, or die by suicide.
7. Poor Support in Crisis Situations
Mental Health America recommends seeking immediate support if you are having a mental health crisis. If you are in a metro area, there is a good chance there is a local crisis center you can contact for support. But for many, it means going to the emergency room. While emergency rooms can provide you with some comfort, they often aren’t fully equipped to provide the level of support you may need.
Resources for mental health care vary widely and there is no standard method for treating a mental illness. In addition, many hospitals are facing staffing shortages with the covid-19 pandemic which means a lack of available mental and behavioral health professionals.
Moreover, stigma and stereotypes interfere with the level of care provided in hospital settings. People who have visited the hospital for a mental health crisis have reported being viewed as “frequent flyers” or “attention seekers”. But the reality is that many have nowhere else to go for support. These false labels can often deter people with mental health issues from going to emergency rooms or needing to advocate for their own health, even if they need support.
8. Cost of mental illness
In the United States, mental health issues cost billions of dollars in direct and indirect costs each year. Accounting for all mental health diagnoses, like depression, anxiety, bipolar disorder, and schizophrenia, the United States spent $225 billion on mental health in 2019 between private insurers and public health programs. While about two-thirds of Americans have private health insurance, the public health sector accounts for most of the mental health spending.
Those who have private insurance, like through an employer or a spouse, will likely have mental-healthcare options available. They will cover most generic medications, psychologists, and psychiatrists. However, oftentimes finding providers who are in-network isn’t easy. Even if providers are in-network, insurance companies will only cover a certain number of visits or amount of service per visit until the deductible is maxed out.
Depending on the doctor and insurance, this could mean paying a co-pay between $15-$60 or even needing to pay for the entire visit out of pocket. The U.S average cost for both psychiatrists and therapists is $100-$200 per session. But many are much more than that, especially if you need a specific type of therapy or area of focus, like cognitive behavioral therapy. Many people start out with weekly sessions, which means they would be paying at least $400 a month on therapy alone.
9. Mental illness is a strength, not a weakness
Mental illness is often viewed as a weakness and a sign someone needs to go to another person who is stronger for help. While it’s true that people with a mental illness may need more help for a period of time than others, it takes a remarkable amount of strength and courage to seek help. Those who do seek help and overcome their illness, are remarkably resilient.
Our society prides itself on self-sufficiency so the idea of asking for help can be daunting. But, the reality is that no one can do everything alone. Because the stigma around mental health is still prevalent, it requires an astounding amount of bravery to ask for help for mental health. There are very few things as vulnerable as sharing with another person what is going on inside your mind and heart, and opening up about experiences you have had that may have contributed to a mental illness.
Living with a mental illness means overcoming added hurdles and obstacles that those without mental illness don’t face. Though there is an added weight, an amount of fighting against your own mind and body every day, people with mental health issues get up and face the day, just like everyone else.
10. No one chooses mental illness
No one chooses to feel sad, nervous, or paranoid all the time. No one wants to have traumatic experiences. No one wants the extra expense of therapy (consider the cost of gas, parking, and travel time) or medications. No one wants to feel isolated or discriminated against.
Mental illness is not a choice. There also isn’t one single cause for mental illness. It can be genetic, biological, environmental, or learned. One person could have grown up in a healthy, loving home and still go on to develop severe depression. While another could grow up bouncing around the foster care system and have slight anxiety.
Despite beliefs, actions, and causes, no one chooses their illness.
You Are Not Alone
If you have a mental illness, remember that you are not alone. There are hundreds of others at PatientsLikeMe who know what it’s like to have a mental health issue and understand the adversities you face on a regular basis. Join the conversation today to learn about how others manage their condition and overcome the stigma of mental illness.