Shirking the Stigma of Mental Illness

Even after more than 20 years in the mental health field, I continue to hear stories of clients stigmatized by the inappropriate use of psychiatric diagnosis, of people waiting years, even decades, before seeking treatment. Some of my clients have hidden the fact that they are in therapy from their family members. Despite the gains we have made as a culture to dispel the negative stereotypes of mental illness and seeking treatment, many people still fear being judged as "weak," "crazy" or "incompetent" for pursuing counseling and/or medications to treat and help alleviate their symptoms, when in fact, resilience and strength are the real core characteristics of individuals brave enough to seek help when they are feeling their worst. I am familiar with the internal struggle clients experience when they must push against these unfair judgements, because I carried those judgments against myself years ago when I was first diagnosed with postpartum depression and prescribed anti-depressants. I'd already been in the social work field for several years, and was regularly attending therapy, which I considered a kind of "weekly visit to the gym" for my psyche and spirit. But after the birth of my son, a crushing depression characterized by nearly ceaseless crying spells, paralyzing self-doubt and a sense of hopelessness about the future frightened me enough to ask my doctor for a psychiatric referral. I was lucky -- I was quickly assessed by a competent physician, prescribed medication that I tolerated well and found helpful in lifting my mood, lightening the darkness that seemed to be clouding my life and provided me with a more realistic perspective on my life and this new chapter in it. I quickly returned to my "normal" level of functioning, and realized that I had likely suffered from a mild depression for as long as I could remember, including throughout childhood. The range of mood, positive outlook and hopefulness I felt once my medication was properly dosed were experiences I'd never had before. I continued to see clients and work with adolescents and adults with a range of life challenges. But my experience with depression -- and even more significantly, with psychiatric treatment and medication management -- offered me a level of empathy and understanding that increased my skills as a clinician. Years passed before I was brave enough to share my diagnosis amd treatment experience with clients. In many instances, it was a "game changer", as clients reported feeling like I "really  got" the totality of their experience.  But I also eventually realized that my depression is simply a thread in the cloth of my life, no bigger or more important than the threads I call "book lover", "amateur chef", "devoted mother", or "unapologetic disco fan." My depression is not a flaw, weakness or shameful secret. It's simply part of me, and likely always will be, like my brown eyes or love of crime novels. When I could embrace all the parts of me, my life and experience without judgement or labeling, I knew I could authentically encourage clients to do the same. We still have a ways to go to see mental illness as we do cancer or diabetes: as a medical condition that occurs irregardless of the character of the patient, and as worthy of effective, timely treatment and compassionate, supportive care. We would never blame a cancer patient for their disease, but rather celebrate their strengths in the face of a debilitating illness and unknown treatment outcomes. I look forward to the time when we approach people living with illnesses like depression, bipolar disorder and schizophrenia with the same empathy, compassion and admiration.

Say What You Gotta Say

Communication issues are a core reason people seek therapy. Whether couples seek counseling to learn how to resolve conflicts or individuals desire to learn assertive, effective ways to share their feelings, therapy can help people develop the skills to speak their truth. But often clients will say, "it won't matter what I say. They won't listen to me." But being heard is not the only endgame of speaking our truth.

Truth Connects Us 

We cannot control whether people listen to what we say. Whether or not people do what we want or respond favorably to our requests, our feelings and opinions still deserve to be aired. Not because we can guarantee the end result, but because we respect ourselves and the other. We demonstrate respect for ourselves when we give our feelings the weight they deserve. With our expression of our thoughts and feelings, we show  others that we respect them enough to be honest and authentic. We become empowered when we resist censoring ourselves. Our courage to be authentic gives others the encouragement to be as real themselves, With genuine conversation, truth-sharing and empathetic expression of our wants and needs, we gain more than being heard, even more than getting the response we want. We develop shared respect, deeper understandings and genuine connections.

"It Is What It Is" -- But IS It?

First used in sociology, the concept of social construction pertains to the ways social phenomena are created, institutionalized and made into tradition by humans. In more everyday language, we name objects, customs and behaviors based on how we see their functions in relation to our times. For example, we see a ballpoint pen and think "a writing instrument." But to our ancestors thousands of years ago, the slim, cylindrical object might be used as a tool to dig in the dirt before planting seeds, or as a "drumstick" to create rhythms when struck against a hollow gourd. Similarly, in modern times, aboriginal people of the rain forest would be unlikely to need an ink pen in their nature-based lives. How we use things guides us in naming them, as does where we are in history. Now, apply this idea to the labels we speak and think everyday. Man. Woman. Teenager. Success. Health. Goodness. Work. Play. Marriage. How do we define what makes up our world? Does the meaning of these words change across cultures, or even within our own lives, as we grow and change? Do we assume everyone uses these labels to mean the same things? By questioning the meaning, appropriateness and effectiveness of our morals, expectations and social rules, we allow for the evolution of greater understanding and compassion to occur. When we pause to explore whether an idea or custom still serves us, we enact the freedom that allows us to embrace new possibilities. Some things in life may remain unchangeable: gravity, nighttime following day, carbon as the basis of human life. But so much that we believe just "is", in reality, is what we choose to call it and how we choose to see it in this moment in time. What is more accurately could be called what could be.