by Muffy Walker, MSN, MBA
Muffy Walker, of the International Bipolar Foundation, will be writing a monthly mental health column for KRL.
Webster’s Dictionary defines stigma as “any mark of infamy or disgrace; sign of moral blemish; stain or reproach caused by dishonorable conduct; reproachful characterization.”
The first known use of the word stigma occurred in 1593, with its origin from Latin stigmata, stigma mark, brand, or from the Greek, from stizein to tattoo.
Those with mental illnesses are unfortunately a target for stigma. Mental illnesses range from a rate of 26.4% in the U.S. to 8.2% in Italy. Combine other groups who are stigmatized against, and we practically have a world of people hating one group or another.
Four of the 10 leading causes of disability worldwide are mental disorders.
According to the 2005 National Co-morbidity Survey Replication study, approximately 1 in 3 Americans experience a mental health disorder in any given year. This translates to over 75 million individuals. Nearly half of Americans will experience a mental health disorder at some point in their lifetime. It is likely that you or someone that you know has or will experience a psychological problem.
The effects of stigma are especially painful and damaging to one’s self-esteem. It leaves people with mental illnesses feeling like outcasts from society. Whether the perceived stigma is real or not, it is the subjective interpretation that affects the person’s feelings of belonging.
Mental disorder can strike anyone! It knows no age limits, economic status, race, creed or color.
Medical science has made incredible progress over the last century in helping us understand, curing and eliminating the causes of many diseases including mental disorders. However, while doctors continue to solve some of the mysteries of the brain, many of its functions remain a puzzle. Even at the leading research centers, no one fully understands how the brain works or why it malfunctions. However, researchers have determined that many mental disorders are probably the result of chemical imbalances in the brain. These imbalances may be inherited, or may develop because of excessive stress or substance abuse.
Why do we, as a society, stigmatize our friends, family, and other members of our community? Perhaps it is due to a lack of education, mis-education, false information, ignorance, or a need to feel superior. The media must also claim responsibility for perpetuating the misconceptions about mental illness. Television and newsprint tend to focus on those who commit violent crimes rather than those with mental illnesses who contribute to our society. These infrequently committed crimes are sensationalized on talk shows, on the cover of popular magazines, and in headline news.
Despite the alarming number of people affected with a mental illness, statistics show that only one-third of these individuals seek treatment. According to Dr. Thomas Insel of the NIMH, psychiatry is the only part of medicine—where there is actually greater stigma for receiving treatment for these illnesses than for having them.
While there are many reasons for the discrepancies in help-seeking behavior, stigma can prevent people from receiving the help that they need. Individuals with a mental health disorder may feel similarly ostracized and feel embarrassed about having a psychological or emotional problem. (Lacondria Simmons: http://www.med.upenn.edu/psychotherapy/Stigma.html)
This barrier to seeking help can have a ripple effect. Some individuals may attempt to handle their “issue” through drugs or alcohol, both of which only exacerbate the illness by increasing the feelings of sadness and despondency. Left untreated, the illness only gets worse causing more isolation, emotional pain, and distress. In some cases, suicide may seem to be the only option.
The stigma impedes recovery by eroding individuals’ social status, social network, and self-esteem, all of which contribute to poor outcomes, including unemployment, isolation, delayed treatment-seeking, treatment-refractory symptoms, prolonged course, and avoidable hospitalizations. (Link, Mirotznik, & Cullen, 1991; Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001; Perlick et al., 2001; Sirey et al., 2001; Struening et al., 2001)
The downward spiraling behavior impacts everyone. The family member, friend or boss who is not privy to the person’s illness, may misinterpret behaviors, once again wrongly judging them.
Stigma, although powerful, does not have to be inevitable. In the next issue, we will learn how to challenge stigma.
Check out KRL’s Mental Health section for more mental health related articles.