Mental Illness, Stigma, and the Dangers of Not Getting Help

So I’ve been putting this one off. And even as I sit here and begin to write I feel uneasy. Even though I am very open about my mental health, I still experience internally imposed and externally received stigma. I fully believe that it is part of what makes me who I am. Yet, I know it can make people uncomfortable and cause them to trust you less. And sometimes others even dismiss you as just being, “crazy.” This is the first blog about my mental health (cue the deep breathing exercises).

I myself had a very public major depressive episode, and eventual break. I know this still colors the perceptions that those around me have of me. And I still experience blame. There are people who say it is my fault and that I could have controlled it if I wanted to. I know that much of this stems from ignorance and lack of knowledge. But what I honestly must say to those people is, “kindly, fuck you.”

In this post I argue that my expletives are warranted. I know what can happen when you ignore your mental health – when hide that you are in pain. Today I’m not going to present you with my full story. Instead I will discuss the dangers of not getting help and the hindering role stigma plays in that process.  

Stigma & Unconscious Bias

A CDC study found that 57% of adults believed that people were caring and sympathetic to persons with mental illness. But, only 25% of adults suffering from mental illness believed that people were caring and sympathetic towards them. Something called the Dunning-Kruger effect could explain this gap. This is the cognitive bias where people who are incompetent at something are not able to recognize their own incompetence.

As humans, I think we would all like to say we are caring to people who have a mental illness. But unfortunately, there is a deeply ingrained, unconscious bias at play. Take the following example. In the media, people are reduced to just being, “mentally ill” far too often. Instead, they should more respectfully be referred to as a, “person with a mental illness.”

By calling someone “mentally ill, you are not acknowledging that they are a person and not just that mental illness. That is a manifestation of bias. How often have you seen a news story about a, “mentally ill” person who has committed a crime? And how often do you independently associate mental illness with other behaviors that you would identify as “bad?”

A Single Story

Photo of Chimananda Ngozi Adichie with a quote that reads, "The problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story."

Let me tell you about a concept called the “single story,” created by author Chimamanda Ngozi Adichie. She uses this term to describe the overly simplistic, often stereotypical, perceptions that we form about individuals, groups, or countries. A lot of her work serves to complicate and disrupt the single stories that many people have about Africa. I think that there are also many single stories that people have about those who live with mental illness.

Let’s do an exercise. Picture a person with depression. How would you describe them? How do you know that they’re depressed? What type of person do you think that they are?

You can keep the answers to yourself, but I hope that you see a bit of what I’m getting at. I had a single story of mental illness, and because of that story, and the stigma I saw associated with it, I did not get help for almost ten years. Let me tell you why.

I was “high functioning.” I was always an “A” student, overly-involved in extracurriculars, and friends with a wide variety of people. Out of college I had a stable job, paid my bills, and was involved in my community. But I was living all this time with almost no quality of life. Six out of seven of the days of the week having thoughts of death and self-harm. This does not mean that I did not have happy moments, but that the pain I was experiencing kept me from truly valuing those moments.

So I hid what I was going through. On the one hand, I didn’t look or act like what I thought people with depression looked like. On the other hand, I didn’t want to make the important people in my life feel unvalued because of my lack of interest and extreme pain. And being in a family in which others suffered from mental illness, I didn’t want to add to any heartbreak. At one point early on I did seek help, but continued to minimize my symptoms to my doctor and to the people I cared about. I didn’t want to put my life on hold and I didn’t want to scare anyone.

The stigma of having a mental illness and stigma of taking the necessary time to treat one kept me from doing so. I didn’t see myself as sick enough to get help and I didn’t want to change what people thought of me. Eventually, I sunk into a major depressive episode. An episode that lasted over a year and a half, and that culminated with me self-harming.

Effects of Delaying Treatment

The longer that one waits to treat their mental illness, the more complicated it becomes and the harder it becomes to treat. Various preclinical studies have shown that delaying treatment of mental illness can cause untreated disorders to become more frequent, spontaneous, severe, and resistant to treatment.

Additionally, a single disorder will most likely progress to more complex comorbid disorders that are harder to treat. You will most likely begin to experience chronic physical problems such as insomnia, gastrointestinal issues, and even chemical changes to your brain and other organs.

Outside of affecting one’s health, leaving a mental illness untreated is correlated to school and job failure and early, unstable, and sometimes violent marriages. At the extreme, some experience bankruptcy or homelessness. Further, there is an increased risk of substance abuse, incarceration, accidents, and suicide.

For those with major depressive disorder, like myself, only 35% are treated within a year of first developing symptoms. For others it can take 4 years or more. Going over a decade without treatment has left me with a lot more challenges to overcome. In addition to Generalized Anxiety Disorder, I also battle PTSD, and now have been classified as having medically-resistant depression as a result of long-term chemical changes in my brain.

Creating Conversation

This isn’t meant to scare anyone, but rather underscore that both stigma and lack of conversation are detrimental to those with mental illness. By othering those who have a mental illness, we push them into a state of fear when it comes to talking about and seeking help for what they are going through. If we can make mental health a part of everyday conversation, then we will create an environment that empowers people to take care of themselves and supports them throughout that process.

Personally, I did not start to get better until I independently made the decision myself to get the real help that I needed. I sometimes think that if our culture was more open and inclusive of people with mental health issues, that I would have sought help sooner. That I would have saved myself years of being numb. But I also had to come to terms with the fact that depression was going to be a companion to me for the rest of my life. It is something that I need to work each day to address. And with that I’ve slowly started to become less ashamed. I wouldn’t be who I am today without my depression.

Irish musician Niall Breslin said something about his depression that resonates with me. Breslin said: “It’s always given me an edge, over everybody else. I truly believe it’s given me an edge, because with depression, nothing can be as bad as that day when you’re stuck in your bed and you can’t get up, and you cannot look at anybody in the eye. So that’s how it’s given me an edge.”

Getting Help

If you are struggling with any kind of emotional distress or mental illness and need to seek help, please utilize one of the resources below:

Psychology Today – Find A Therapist, Counselor – https://www.psychologytoday.com/us/therapists

National Suicide Prevention Hotline – 1-800-273-8255

National Alliance on Mental Illness Helpline – 1-800-950-NAMI (6264) or info@nami.org

The Geography of Fear

In a previous post, I glossed over the term “geography of fear.” Paradoxically, this isn’t something that is possible to just gloss over for many women, including myself. The geography of fear affects me everyday, and it’s something that is always in the back of my mind.

Woman standing on street alone in the dark.

Before I give you a text book definition. Let me tell you about something that happened to me last week that has been haunting me.

My apartment building is under renovation, which means there are numerous construction men and contractors coming in and out at all hours of the day. Typically, they go about their work without interaction – except the occasional hello. Then I saw a new face. Every time I walked through the hall, or in and out of the building, this man insisted that he either make some sort of comment to me, or try to engage me in conversation.

The first few times was okay, and came off friendly. Then it became more intrusive. Which brings me to last week.

He stopped me to ask me a question, which I entertained. But then he asked me which apartment was mine. I was uncomfortable, and didn’t want to be impolite, so I answered him, and immediately regretted it. Shockingly, I told a man that I did not know, who had been giving me creepy vibes, which apartment was mine.

I began to fear that he would come knocking on my door. Or that he would use the master key to enter my apartment. I was happy that I was housesitting for a few weeks, because the last thing I wanted to do was sleep there.

What is the geography of fear?

The geography of fear is a concept that arose from sociology and criminology studies which demonstrated that women, as a gender, are more fearful of crime – often related to a sense of physical vulnerability to men. We warn women from going certain places alone or at night, simultaneously forcing responsibility for their own fate onto them. We make assumptions about women’s lack of freedom to be in public spaces and at certain times. And that assumption is that we shouldn’t be.

My grandfather told me many times that I should not go anywhere alone. That I shouldn’t travel alone, or drive in certain areas alone. And that I especially shouldn’t do any of that at night.

woman alone in parking garage, clutching purse

I have heard these messages from a very young age, as I’m the case is for other women. I know that I have internalized them. If I see a man that I perceive as threatening, walking towards me, I cross the street. I get my keys out and place them in my fist when I walk to my car at night, then look inside my car before getting in. Sometimes I pretend to be on my phone to give the guise that I would have a witness if anything happened to me. Or I actually call someone while I walk home in the dark because I’m scared.

And I do all of this resentfully. Because I’ve watched my younger brother not have a curfew, or warrant the same concern from my parents when he’s out late. And I wish sometimes that I felt powerful enough to go where I would like to, freely. But my geography of fear might be a little more heightened than the rest.

Violence Against Women

I’ve always wondered where my generalized anxiety came from. And recently in therapy I’ve figured it out (therapy is cool).

When I was in seventh grade, my favorite dance teacher was murdered. I was extremely distraught and confused, but I was also scared. They didn’t know who did it. In fact, they didn’t find her killer for a few years. I had this sense of impending doom that something could happen to me, or someone that I love, at any time.

My teacher also lived alone, with the exception of her dog. She was a woman, alone. An an older woman, a strong woman. Yet there was nothing she could have done to prevent what had happened to her – in her own home. The majority of gun victims and sexual assault victims know the perpetrator. Someone she knew killed her.

Ever since then, my life has been marked by extreme anxiety. But a large part of that relates to the geography of fear. And the fact that even my own home could be a place that I shouldn’t be alone. I’ve struggled with insomnia for years, and the only time I’ve ever be able to sleep through the nights soundly, was when I was in a relationship.

In conjunction with other things that have happened to me in my life, sometimes I sleep with the light on. Sometimes I keep a knife at my bedside. Or occasionally, I check all the locks on my windows and doors, look under my bed, and inside my closet. Finally being diagnosed with PTSD helped me to make a lot of sense of what I was going through – and what I still sometimes fall back into.

Stay sexy, and don’t get murdered.

At the same time of my diagnosis, and my moment of clarity about the start of my anxiety – I started listening to the podcast My Favorite Murder with Georgia Hardstark and Karen Kilgariff. It really wasn’t until then that I started to feel more powerful.

Karen Kilgariff and Georgia Hardstark

A 2010 study found that women are more likely to be fans of true crime than men are. Karen and Georgia attribute this fascination as being related to a women’s desire for self defense. And I concur. By listening and learning to story after story of violent crimes against women, you learn how to (1) deal with the fear and (2) think about how you would act if you found yourself in a similar situation. The same study suggests that it is a way for women to deal with the deeply engrained misogyny in the world.

Karen and Georgia continually assert that women should fuck politeness. That we shouldn’t feel obligated to be accommodating and nice to everyone, especially when we are uncomfortable. Notorious serial killer Ted Bundy lured too many innocent women, usually by faking injury with a cast. As women we feel obligated to be helpful – but if we get a bad vibe, we shouldn’t push through our discomfort. We should say no.

Let me tell you, I wish I would have fucked politeness, and told the construction worker in my building that I didn’t feel comfortable giving him that information, and to let me come and go without interruption. But more often than not, it’s hard to take your own advice.

fists that read "fuck politeness"