Many factors contribute to stigma in mental illnesses but an important one involves assumptions made when two people experience the same circumstances. It is natural to assume that if we both stub our toes, we will experience similar pain, or if we both lose our jobs we will both have the same reaction. In reality, experiences are subjective. The experience of an event cannot be separated from the person living that event.
In the example of stubbing a toe, some people may claim that a stronger person can tolerate more pain and hence complain less. But how do we know if both individuals have the same number of pain receptors in their toes? Or that the one person may have more calloused skin, or may have been lucky enough to receive the brunt of the force between two receptors?
And if one person is indeed stronger and can tolerate more pain (assuming we could accurately measure force on receptors), what has gone into making that individual stronger? I certainly did not choose my genetic make-up, my upbringing, or the events around me that made me who I am. As Popeye says, “I yam what I yam.” What make us strong or weak is rarely of our choosing.
It is in this sense that I wrote the February 8th column. It examines the differing reactions to a death of a loved one. It is not unusual to hear of a person taking time off after a death. These leaves can sometimes go on for weeks, months or years. Yet there are also plenty of people who return to work immediately. The fact that we may have gone through the same circumstances as another individual leads us to believe our grief is similar. It is not difficult then to believe the person on leave is either malingering or is very weak. While there are undoubtedly some malingerers around us, it is unfair to assume everyone is.
I think the subjective nature of our reactions is a major contributor to stigma in mental illness.
Two deaths, two reactions
(Source: Deux décès, deux réactions. Journal Métro, February 08, 2011)
Stigma is one of those things that add unnecessary suffering to our lives. Just like any other form of prejudice, its impact would disappear if our attitudes changed. For the mentally ill, unfortunately, stigma is part of the package.
If you developed a neurological disorder and found yourself in a wheelchair with limited movement it would be quite a devastating blow. Now imagine that people shunned you out of fear. Worse still, imagine they accused you of laziness and of faking your illness to avoid responsibilities. Such is the burden of mental illness. Intolerance and lack of empathy compound the illness.
Two of the most common forms of psychological disorders are depression and anxiety. While they may not completely disable us and may not always be obvious to others, the stigma associated with these conditions forces many people to suffer in silence.
I’d like to propose a toast
Stigma is fed by lack of understanding. Take an anxiety disorder. If we are comfortable giving a speech or traveling by airplane it may be difficult to imagine why another person would have a problem with these activities. Yet there are many competent people who drop out of school or refuse promotions because of such fears. Anxiety disorders can seriously impact people’s lives. When we do not share someone else’s anxieties it is difficult to empathize and to not judge them negatively.
Two deaths, two reactions
Depression is another condition that is highly prone to stigma. The reason for this is our mistaken assumption that similar circumstances will be lived by two people in the same way. While we can easily imagine another person’s circumstances – indeed we may have lived them ourselves – we will never have lived them through another person’s mind.
If two people lose their fathers, one may continue to function as before, while the other may become seriously depressed and unable to work. In such a case, it is not difficult to imagine the first individual accusing the second of malingering. Yet no two of us will have the same reaction to a death. Our reaction will depend on our spiritual beliefs, our personal strengths and weaknesses, our level of emotional reactivity, our previous experiences with grieving, and the kind of relationship we had with the deceased.
Ultimately what feeds stigma in mental illness is that the illnesses themselves are hidden. We can detect a shriveled body ravaged by ALS. We can detect shriveled memory ravaged by Alzheimer’s. But while we cannot easily detect a shriveled sense of self-confidence caused by depression or anxiety, the effects are just as real.
22 Feb 2011