Thursday, April 4 2013

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mental health labels mental health stigma

Image Credit: Leonard John Matthews | Flickr

In this blog Xin takes a look at how a mental health label can impact on you and how others perceive you, sometimes this can be helpful, and other times we have to take a moment to look beyond the label given.

I recently wrote a blog article on the power language has of shaping the world. But I’d like to have a closer look at a more specific way that people can unwittingly limit other human beings, or worse, themselves.

In the very first verse of the Tao Te Ching, Lao Tzu says that if you can name something, you limit it in the naming. For example, if I think of someone as a “cleaner”, that’s all I’ll ever see them as. Yes, they clean things, but I’m excluding all the other dimensions of their person, and all the other kinds of relationships I can have with them. No person can ever be described with a single label, yet often that’s how we operate as a species to make sense of this overwhelming world we live in.

Life is too complex to understand every aspect of every idea and object – if we’d try, our brains would explode, especially as children who have little structure for organising their knowledge. To make it easier to process this incredibly complicated world, we divide things into bigger and broader categories. For example, a two-year-old might think that all things with four legs and a tail can be described as “dogs”- it’s only as they grow up and process more and more information that they start to differentiate into smaller and more specific categories. Schemas (for that’s what such categories are called) are a useful and necessary function for humans to organize their knowledge of the world. But they can be extremely unhelpful and limiting, especially when applied to people. In particular, I find them incredibly frustrating when talking about mental illness.

Recently I was diagnosed with a mental illness (though I struggle to use even such a term as that – I think the word illness implies a sickness that needs to be cured. I prefer to think of it as a characteristic of my personality that’s neither good nor bad, but helps make me who I am). Let’s say I have schizophrenia. Are you concerned that I’m delusional? What if I said I had depression – would you be worried about my emotional state? How about bipolar? Multiple personality disorder? I haven’t changed at all, but has your opinion of me?

mental health labels mental health stigma

Once you read the label - will see anything other than that? Image Credit: Mrs Magic | Flickr

It is the automatic reaction of most people to think differently of a person just because they are aware of the label. This prejudgment is a totally understandable and necessary function of human understanding. Psychologist David Rosenhan used this to his advantage by conducting a study where several of his students submitted themselves to psychiatric wards by pretending they could hear voices, that they were delusional and other symptoms of schizophrenia. Once they were admitted, they stopped pretending they were mentally ill and behaved as normal, and they waited to see how long it would take before the staff let them return to the community. They stayed in the psychiatric ward for nineteen days on average before they were finally allowed to leave.

When one of these psychiatric hospitals discovered the hoax that had been played on them, they were outraged. They put a challenge to Rosenhan to send out as many actors as he liked, and they would correctly identify them in order to prove that they were accurate in their diagnoses. Over the next few weeks, the hospitals identified several dozen people they suspected could be accomplices in his experiment. When the time came for him to reveal how many pseudopatients he had sent out, he surprised them all by saying “Zero.” The hospitals had been unable to tell whether their own patients were mentally ill, or ordinary people with ordinary problems.

I need to clarify at this point that I’m not saying mental illness isn’t real. For many people, there are serious and recognisable symptoms that indicate they are struggling with issues perhaps beyond their control. Many of these people will find their lives improved with treatment, psychological, psychiatric, or pharmaceutical.

But I know from my experience of the mental health field that having a mental health diagnosis can be extremely limiting. If a medical professional is reading your medical file and they see “depression” on there, it’s quite likely they’re going to treat you as if you’re a depressed person. Or a neurotic person. Or a potentially psychotic person. Worse, colleagues, acquaintances, employers and friends can start to treat you very differently if they discover that at one point in time, one person once described you with a mental illness label.

Don’t get me wrong, diagnoses can be tremendously helpful. In my case, I was so relieved to realise that the quirks that make me who I am, but also cause a fair amount of distress in my life, are partially attributed to a mental health disorder. But I also don’t want to be bound and limited by the nature of my disorder, and I certainly don’t think of myself as ill. I’m exactly the same person, but now I’m more aware of my nature and I’m better able to care for myself as I relate to my disorder.

I’m exactly the same person, but now I’m more aware of my nature and I’m better able to care for myself as I relate to my disorder.

In my personal opinion, the Diagnostic and Statistical Manual (DSM – the massive book that mental health workers use to diagnose and differentiate mental illnesses) is far too big. It gets really, really specific about symptoms and diagnoses, to the point where normal human behaviour might be interpreted as a sign of mental illness. For example, if a person has been grieving for more than two weeks, it might be justifiable to say that they have major depressive disorder, even though what they’re experiencing could be perfectly natural.  The DSM is remarkably useful, but only to a certain extent – after a while, I think the boundaries start to blur. Trying to separate and categorise the broad spectrum of the human condition into a manual of illnesses just doesn’t work.

Having said that, I also acknowledge that some mental illnesses really do benefit from being treated as if they were illnesses; medication can make a huge difference to people’s day-to-day lives, so if you have a mental health disorder and your medical professional has prescribed you something, don’t stop taking it. If it helps you, do it. If it doesn’t help you, find something that does. Again I stress, if you’ve been advised to do something by a mental health professional, don’t just stop doing it because of something you read on the internet. But really take a good hard look at your relationship with whatever diagnosis has been applied to you. If you think your current treatment might be improved by more socialising rather than more pills (or whatever the case may be), ask your mental health worker to give it serious consideration. People are human, even the ones it labcoats, and there’s a startlingly high rate of misdiagnoses in the mental health profession.

So if a label helps you understand and relate to yourself, that’s fantastic.
But if you don’t think a label suits you, don’t let it define (and therefore limit) you.

Above all, remember that you are a person, not a disorder.
You are exactly as much as you think you are, no more, no less.
So whoever, wherever you are, be the best person you can be.


Thanks to Xin for another great post. If you would like to see your blog published here contact us as we on the look out for some new youth producers to join our team.

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