A Primer on Depression and Bipolar Disorder

G. Stigma Of Having A Mental Illness - Part II

Having put in a bad word for television above, let me now praise it for a documentary program which I saw on PBS in the winter of 1986/87 (I was still pretty shaky then, so I must be forgiven for not remembering exactly when, or the title, or other trivial facts). The program described the life of a small group of people who lived in a mental half-way house in Minneapolis; they were provided meals, helped with daily tasks, and supervised by workers at the house. They had freedom to go out to work, classes, and other activities. Most of the program was devoted to explaining and illustrating their lives. But two vignettes tell the essential story. At one point the narrator was interviewing a man suffering from bipolar disorder. He had experienced an episode of major depression several months ago; as a result, he lost his job, then his home, and then his wife left him, taking their son with her. After becoming unable to care for himself he was hospitalized and started on medication, which resulted in significant improvement. Now in the half-way house, he was visited by his small son every weekend. In the interview this man was asked "If you could have any wish you want, what would it be?" Holding his son in his lap he responded, almost in tears, "I would just like to be like all the rest of you. I would like to be normal!"

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 person with chronic mental illness from seeking adequate treatment. As described above, I felt this influence myself at the end of 1997 when I was considering changing the 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 having been a distinguished university professor, and now a productive physicist at a major national laboratory, 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 has 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 have led (and created) self-help groups; this was often 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 people with CMI can't afford to be so open; many 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 Hillel's 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 have ever wanted to be, so it might as well be me.

For the rest of us, the first step is to become informed. Several good books are listed in the Bibliography. Then speak out firmly and truthfully against words or acts that discriminate against someone just because he/she has been afflicted with a mental illness. Participate with groups and in community actions that can lead to improved care and services for people who have 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 have 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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