The Invisible Stigma
Recently I read an article, frankly
it was a rather superficial piece, on mental health, published originally in a
Mommy Magazine, but it got enough interest that it was republished online via
CNN. The interesting thing about it, is that my first immediate reaction upon
reading it the first time was outrage. I reposted the article along with a
diatribe. This isn't anything new, I have some of the most interesting
discussions when I get irate about something, but this time something unique
happened.
Over the course of the day when
different people saw the link, I got two very polarized responses. The first,
irate agreement with my annoyance, the second was polite confusion trying to
pinpoint what exactly had struck me so wrong. It was the second response that
made me think. I reread the article, trying to pinpoint the exact phrases that
set me off, and they were there, but it was a subtle game. The article never
directly said anything pointed, in fact it was the very calm, nonspecific nature
of the piece that made it all the more frustrating, and all the more difficult
to combat.
I'll bring back a link to the
article, and discuss my arguments about it at length further on, but first a
little background on me, and the experiences that have affected my perception.
I was diagnosed 'depressed' at
seventeen. This didn't come as a surprise to anyone, I'd known I was unhappy,
and frankly sick of fighting an endless battle with my sadness, apathy, and
loneliness. It was back in 02, and even though more and more people were
learning about depression, aware that it existed, and the TV and magazine ads
for prozac had already started making the rounds, it was still something no one
really wanted to admit happened to them.
I had a lot of reasons to be
depressed. In addition to the dramas of adolescence I'd been fighting a long
hard battle with another invisible disease, Ulcerative Colitis, that left me
dangerously underweight, exhausted, wary of everything I ate, and frequently in
the hospital. The thing is, depression doesn't care if you have a reason to be
depressed, reasons just make it all the more difficult to fight it. Getting
diagnosed with depression was a relief, it gave my problem a name and a
description of ways to combat it. Like my other disease, not knowing what was
killing me was far worse than giving it a name.
The irony in my struggle is that if
I told people I was depressed and taking antidepressants as a teenager, they
had no argument with that. For most it was something so indefinable, that they
didn't bother to question it, they just accepted it. No, the irony was in the
way people reacted to my actual physical disease. I had UC. I was diagnosed by
doctors through many, many tests. I went through many courses of medication. I
had a doctors note requiring teachers to forgive my absences because sometimes
I was in the hospital, sometimes I just couldn't get out of bed. But when I did
go to school, it was such a relief to see my friends, I preferred to act like
nothing was wrong. I joked with friends, goofed around, and tried to have a
normal school experience.
Some people couldn't accept that.
Teachers, especially, couldn't grasp the idea that I could be deeply ill, and
yet joke with my friends during class. They assumed I wasn't trying hard enough
to do their coursework, some seemed to assume I was outright 'faking' a disease
to get attention. I was deliberately failed by one teacher, despite my A on the
final exam. Another teacher refused to give me a letter grade, and only
supplied a 'course completed' stamp that got me out of her class without
contributing to my GPA. Passive aggressive punishment for having a legitimate
disease.
I am far more bitter about the
experiences I had at the hands of adults, I admit. There were other incidents
with students, more petty and cruel, but I don't expect better from teenagers.
Stupidity at sixteen is almost required. It was the people that should have
known better. Those that should have been past such petty judgments, those are
the wounds that I remember.
It was situations like this that
made me all the more sensitive to meta-messages. All the things you read
between the lines, all the cruelty and subtle emphasis you make clear without
ever saying a word. I think many people who become depressed are more sensitive
to the opinions of others. Many of these people are highly intelligent,
artistically inclined, and clever enough to see through the fronts others put
up.
This might make them too sensitive,
maybe even paranoid at our most insecure, seeing daggers in every sigh, and
judgment in every silence. But we aren't stupid, and when we say people judge
us for our 'mental disorders' we aren't wrong.
I was fortunate to know, quite
acutely, that I was depressed, and I needed help when I first sought it. It
made it easier to accept the diagnosis, but it didn't mean it was easy to stay
there. Depression is like a cancer, you can beat it back, and sometimes go for
a long time free of it, but there's no guarantee that it will stay gone, and
all too often it comes back. To make matters worse, it might not be just
depression. It might be anxiety caused by stress factors that you can predict,
or panic attacks that come on violently for no reason. You could be diagnosed
depressed, but actually suffer from a manic depression where half the time your
unable to sleep, sit still, or stop chasing a dream, then you crash and fall
into a pit of despair and lethargy. Mental disorders are tricky to face, hard
to diagnose, and even harder to treat long term without difficulty.
Yet, if given half the chance, I'm
sure almost everyone you know can tell you a 'solution' to your problems.
Everyone has been sad, or unhappy at some point, but not everyone has been
depressed. The fact that so many people believe sadness, mourning, or normal
unhappiness is equal to clinical depression is one of the hardest logical
fallacies for both depressed and 'normal' people to overcome.
If I have an ugly infected boil on
my toe, it takes a special kind of person to give me advice on how to cure it,
let alone someone who'll want to talk about it at all. Yet if you say you're
"depressed" for most people they assume it's your way of asking them
to 'fix it', and they'll try. (Sometimes I wish Depression had a fancier name.
I think I'll start calling mine 'Johnson's Apathy'. If I tell people I'm on
medication to cure my Johnson's Apathy maybe they'll stop telling me how I can
quit my pills and just take a vacation instead.)
People who have fought the battle
for their mental health, especially people who are willing to talk about it
openly, have all dealt with the oftimes crushing advice on how to get better. "Just
try to cheer up." "Maybe you need more sunlight." "Maybe
you need more vitamins." "When I'm sad I just…" "If your so
stressed, you should take some time off." "You need to get out
more." "You need to relax more." "Get a hobby." And
the far worst one, the one that so few actually say, but we can read it loud
and clear between the lines. "Maybe it's all in your head."
"Just stop being that way."
Passive aggressive, condescending,
sometimes well meant, but all the more painful, the advice from people who've
never truly understood mental disorders all carries the same stigma, "I'm
fine. So what is so wrong with you?"
People with depression aren't seen
as 'sick', they're seen as weak, unmotivated, not 'really trying' to get
better. The burden of the judgment can be a weight that crushes you, especially
when you're already deeply convinced that you cannot escape your flaws. Someone
who is depressed, but afraid to be labeled 'mentally ill', will run from that
stigma. Sometimes until it kills them.
I am fortunate. I know that
my depression is a physical chemical imbalance that I need medical help to
manage. I know my depression is not a sin, a personal flaw, a choice or
a weakness. I know that I cannot always help the sadness that swallows
me whole, and that when that happens, my job is to get support, see my
Doctor, and remind myself that it will get better. You know what, even
though I know all that with the same certainty that I know the sun will rise…
When I am depressed, it doesn't stop me from hating how I feel, hating who I
become, and feeling like a burden and a failure to my family.
Knowing that depression is a
disease I can fight, with proper medication, therapy, and support of friends
and family is the rope I need to climb out of the pit that depression throws me
into. Having the certainty that I will keep fighting, and this is not
my fault is all the difference in the world sometimes.
This is why a fluff piece in amagazine offended me so much. (Specifically titled, "Xanax Makes Me a Better Mom") The article began with a 'depressed' mother who
went off her medication and 'cured' her depression with moments of solitary
meditation, the article ended with a 'depressed' mother who's daughter said 'she
feels sad' (An early sign of depression, though in a child it's contingent on a
LOT of factors, like duration, severity, frequency, before deciding it's an
actual concern.) so the Mother's conclusion from her daughter's sadness was to
go off her medication and try to deal with her disease (and her potentially
depressed 6yo) unmedicated.
Basically looking at the structure
of the article, if you begin a news piece with a statement about using
alternative (to medication) methods to combat depression, then end that piece
with a similar statement about getting off the pills and reconnecting with
life, the position of those two pieces make them your strongest 'argument'.
Thus, the article is saying "American parents are over-medicated and need
to stop taking pills in order to better experience life".
This is why I found the article a
bit offensive. If you also look at the statements they included in the article
statistics from the CDC stating one in ten people are on antidepressants,
include a therapist who thinks people just want a pill to deal with normal
feelings in life, and a snippet from a psychologist who says taking pills
without seeing a therapist is never going to fix the problem. Even though they
couched all this language in fuzzy anecdotes about parenting and interviews
with parents on medication, their implication is clear. "You don't need a
pill. You just need to get over it."
The stigma is right there, wrapped
in statistics, and couched in anecdotes. "They fixed their depression. Why
can't you?" "You don't need medication." "People just want
a pill to deal with normal sadness." The words are there, "It's just
easier to take a pill." along with the implication, you are weak for
needing a pill to survive your illness. You are a failure for 'not facing' your
depression and getting over it. You are broken.
If someone is depressed an already
hating themselves then all they see from these words is not an offer of help,
or an observance of the medical possibilities for getting better, instead they
just see how they can't fall into the fallacy of the over-medicated society.
The thing is, there are probably a
great many people who are not clinically depressed, but have had a rough time,
get on a dose of pills to get through it, and never think to stop. There are
probably many people who would benefit from therapy to deal with traumas and
triggers in their life that still effect them today. There are even people who
are depressed, but choose to face it without medication because they feel they
know what they're doing and they know the risks.
The problem isn't if people
are taking too much medication, or if it's the wrong medication. The problem is
that we don't bother to learn what depression is, how to help, and what to do
to support those who have it. Instead we assume the media is to blame, that
people are taking pills they don't need, and no one has a legitimate
illness.
Doing that just takes us backward,
and leaves us marginalizing mental illness, reducing it to 'an illusion' and
stranding the legitimately sick people without aid, and without the understanding
they desperately need. Depression is a captor, it takes your mind, it tears
down your confidence, it divides you from your ability to judge rationally who
you are, and if what you’re feeling is normal. If everyone who isn't depressed
learns to think it's all a lie… then who will be there to help the person who
can't help herself?
Every article that boosts the
stigma that mental illness isn't 'really a disease' does damage to the way
people perceive mental illness, and each other. My biggest fear is that too
many people will believe that lie, and those of us who need help will be left
to die by inches, imprisoned in our own minds.
