A Primer on Depression and Bipolar Disorder

II. MOOD DISORDERS AS PHYSICAL ILLNESSES

G. Stigma Of Having A Mental Illness (cont.)

The second interview was with a woman suffering from Tourette's Syndrome, a brain disorder which produces uncontrollable tics, or causes the victim to utter involuntary words or noises. In this case, the woman, in the midst of normal conversation, would suddenly utter a string of obscenities and profanities, lapsing immediately back into normal speech. She was considered unemployable as a result. When asked the question "If you could say something to all of America now, what would it be?" Her immediate response was "I would just like people to know that we can't help what we do!"

The message is clear: nobody wants to be mentally ill. Those who are can't help what what happens as a result of the illness. And the thing they want most of all is to be well, to be normal, to be just like everyone else. Anyone with the tiniest shred of humanitarian instinct will realize that these are not people to stigmatize, ostracize, or punish. These are people who urgently need help, and who, when they get it, often can return to perfectly normal, productive lives.

Perhaps the worst aspect of stigma is that it prevents the CMI (chronically mentally ill) person from seeking adequate treatment. I felt this influence myself at the end of 1997 when I was considering changing which antidepressant I was taking. Fortunately, in the end I realized that the correct approach was "stigma be damned! I want to get better!"

So what can we do to overcome the stigma? Let me say first what I do: I am completely open about my illness with anyone who wants to hear about it; I do not try to hide it, nor am I ashamed of it. I have an advantage over most people in this regard, because being a university professor I have a high degree of job security in a generally supportive environment.

My goal is to let people know that though I look and act just like they do, I am someone who is CMI, that I have been severely incapacitated before I got proper treatment, and that adequate treatment has restored me to a full productive level. I also lead self-help groups; this has been a difficult, but rewarding, experience. I talk to various groups about depression and bipolar disorder. Occasionally I write about it, for example what you are reading at this moment.

Other CMI people can't afford to be so open; most of them would lose their jobs if their employers knew they were ill. It's a catch-22 situation. So I have taken to heart the old rabbinical questions "If not me, then who? If not now, then when?" The time for change is now; the time for increasing understanding and breaking down stigma is now. And I am far better qualified, alas, to talk about my illness than I had thought was ever possible, so it might as well be me.

For the rest of us, the first step is to become informed. Several good books on manic depression and bipolar disorder are listed in the Bibliography. Then, speak out firmly and truthfully against words or acts that discriminate against someone just because he/she is mentally ill. Participate with groups and in community actions that can lead to improved care and services for people who are CMI. Support national, state, local organizations devoted to the various aspects of mental health and mental illness. Be friendly, supportive, and encouraging with people who are CMI with whom you come in contact; their lives are already too hard, and even the smallest gesture you can make will mean a great deal to them.

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