Would you think less of a family member if s(he) had heart disease? Kidney failure? Hepatitis? Would you be hesitant about getting your loved one to medical care? Would you decide the best solution would be to get the person admitted into an institution and put him or her away for life?
The answer to all these would likely be a resounding “Never!” Why then do most people have a different kind of answer when the illness involves not the heart, kidneys or liver – but another body organ, the brain? As we hurtle down the third millennium, pushing forward the frontiers of medical science, upping the ante on our own awareness of healthcare, mental illness still remains an area of darkness, providing fertile soil for ignorance, fear and shame.
Thus, even in 21st-century India, mentally-disturbed persons in rural areas are subjected to atrocities such as being shackled in chains, being beaten in order to “force out” the evil spirits that are believed to have taken up residence in their bodies, or having their eardrums punctured with sticks or pins, again in an attempt to provide an exit point for the alleged evil spirits. Apart from evil spirits, other agents blamed for mental illness include the curse of God, the evil eye, karma, loss of semen or vaginal secretions, witches, ghosts, air pollution, or problems in the horoscope (“kundli”).
Non-enlightened attitudes also thrive in urban India. Thus, research published in The Indian Journal of Psychiatry reveals that, among city-dwellers, even university graduates and those who profess not to believe in supernatural causes of mental illness, have yet consulted faith healers rather than mental health professionals. Meanwhile, nearly half the doctors surveyed said that they would oppose marriage to a person who has recovered from a mental illness.
The profound stigmatization has serious consequences for those who suffer from mental disorders (and their numbers are growing by the day). It not only results in bias and stereotyping, but also fosters fear, anger, embarrassment, and avoidance of the mentally ill. They face rejection not only in getting a life partner but also in job opportunities, besides the denial of basic human rights and freedoms.
The bottom-line: When most people think “mental illness”, the sub-text that races across their minds is: “Incurable”; “Runs in families”, “Affects weak people”; “Must stay away from them”; “Don’t want to know”.
Browse through the most popular myths, below – and the facts that de-bunk them:
1. A mentally-ill person is crazy.
“Crazy” is a generic term which is meaningless in this context. Everybody is crazy a little bit, some of the time. Having a mental disorder, however, just means you have a problem, similar to any other disease, which needs treatment.
This is perhaps the core fact that most people haven’t yet come to terms with – that mental illness is an illness like any other. Yet, it’s true: Brain disorders are as much legitimate medical illnesses as heart disease and diabetes. Research shows that, as in the case of physical illness, so too in the case of mental illness – there are both, genetic and biological contributors. In the case of mental illness, two postulated causes currently being researched are: a genetic susceptibility (by way of one or more inherited genes), and a chemical imbalance in the brain. We also know that life circumstances involving severe stress (such as the loss of a job or of a loved one) can provide the trigger that brings susceptibilities to the fore and sets off an emotional disorder such as depression or schizophrenia.
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Bantering words like “crazy”, “cracked”, “insane” , “weirdo”, “psycho”, “loony”, “nuts” , “loose screw”, “retard” and “paagal” are not only offensive and hurtful to someone who’s battling a mental disorder, they also send the message that it’s okay to trivialize mental illness. (It has been estimated that there are at least 250 words in the English language alone that stigmatize the mentally-ill by their demeaning overtones).
Instead of using a filler word like “crazy”, choosing a precise word like “depression” or “phobia” is more accurate and non-judgmental.
2. Mental illness is lifelong and incurable.
In fact, long-term research has shown that mental illness is successfully treated at a much higher rate than other chronic health conditions. Treatments are effective 60 to 80 % of the time. When treated appropriately and early, many people recover fully and have no further episodes of illness.
Some mental disorders may involve relapses, particularly if the person is exposed to the same conditions (e.g., severe stress) that triggered the illness in the first place. But if the person has learned the required emotional skills through psychological treatment, (s)he will recover faster and with fewer complications after a relapse.
For others, mental illness may recur throughout their lives and require ongoing treatment. This is similar to many chronic physical ailments such as diabetes and heart disease. Like these other long-term health conditions, chronic mental illness can be managed, though not cured.
Only the seriously mentally ill (about 1 to 2% of the population) never improve to a satisfactory extent; but even they can function a lot better with professional help. Treatments in this field are improving all the time and have, in recent years, become increasingly effective.
The roster of successful people who have lived with mental illness is long and includes such well-known names as Abraham Lincoln, Florence Nightingale, Isaac Newton, Charles Darwin, Elton John, J.K. Rowling, Leonardo DiCaprio, Deepika Padukone, Shah Rukh Khan, Jim Carrey, Ted Turner and John Nash, the Nobel Prize-winning mathematician whose decades-long struggle with schizophrenia was portrayed in the movie, “A Beautiful Mind”. All these people (and thousands of others), though suffering the symptoms of mental illness, still lived full and productive lives, remained engaged in the world and received public and / or professional acclaim.
The belief that mental illness is incurable results in many sufferers not getting to available treatment – either they and / or their family members consider it useless, or the doctor they consult does not refer them to a mental health professional. Research in India finds that less than half of those who are affected by a mental health condition are availing the professional services that could benefit them.
3. The mentally ill are often dangerous and violent.
This false perception underlies some of the most damaging stereotypes. It is a myth that has been reinforced by media portrayals that show people with mental illness as frequently violent. What studies on the ground actually show is that the vast majority of the mentally ill are not violent (provided they don’t abuse alcohol or street drugs). As a group, they may, in fact, be less violent than the average person. Only 3 to 5 % of violent acts are committed by persons with a serious mental illness, and even in these cases the mental illness alone doesn’t account for the violent behavior. Generally, it is when the mental illness meshes with other variables — including substance abuse and the presence of stressors (e.g., unemployment) — that crimes of violence may result.
The fact is that those suffering from a serious disorder such as schizophrenia are more often frightened, confused and despairing than violent. They are more likely to be victims than perpetrators. Physical and sexual abuse, particularly of mentally-ill destitutes, is common.
There’s one more thing. Research has found that a violent crime committed by a person with mental illness is more likely to get the front page than a crime committed by a person without mental illness. Just as we hear more often about plane crashes than road accidents (although the latter are far more common), we hear more about people with a mental illness being violent. The news that’s presented to readers (or viewers) is, of course, selected – often for its sensationalism quotient. So, you’ll get very few stories about everyday people who happen to be dealing with a mental illness.
4. Depression results from a personality weakness, and the person just needs to snap out of it.
People often do not sympathize with someone who is experiencing depression because they make a value judgement about the person, believing that he lacks the will-power to pull himself up and is just not making an effort. But “major depression” (which is a different kettle of fish from the garden-variety blues that all of us experience occasionally) has nothing to do with being weak or lazy. It cannot be willed away. It is a real, treatable illness, caused by a complex interplay of genetic, biological, social and environmental factors that are still being teased apart in current research.
Major depression can happen to anyone – people who are ‘normal’, ‘average’, successful, wealthy, super-achievers, or any other category you can think of. Just as any of us could get a cold, sore throat or upset stomach, so too can we all suffer depression, depending on our susceptibility (in terms of our inheritance and our life circumstances).
5. Schizophrenia means split personality.
This is one of the most popular misconceptions. But a diagnosis of schizophrenia does not mean “split personality” such as a Dr Jekyll / Mr Hyde switch in character. The word, “schizo” does mean “split”, but the Swiss psychiatrist who coined the term, “schizophrenia”, used it to mean a split from reality. The schizophrenic suffers a break with reality, a “split” from the real world. He is locked away in an unreal world of his own. The typical symptoms of schizophrenia reflect this break with reality: a rupture in the thought process, delusions and hallucinations, social withdrawal, apathy.
A mental condition completely different from schizophrenia does involve a person’s identity being fragmented into two or more distinct personalities, which alternately take control of the person. This condition used to be earlier called “Multiple Personality Disorder”, and is today called “Dissociative Identity Disorder”. It was famously depicted in the movie, “The Three Faces of Eve”.
6. Alzheimer’s happens only to older people.
While it is true that old age is the single biggest risk for dementia, and that most people with Alzheimer’s are 65 and older, this disease can occur at a much younger age, too. About 5% of people with Alzheimer’s get symptoms in their 30s, 40s, or 50s. It’s called early-onset Alzheimer’s, and likely has a genetic basis. Scientists believe it involves changes in one of three rare genes passed down from a parent.
People who have early-onset Alzheimer’s often go a long time before getting an accurate diagnosis. That’s because doctors don’t usually consider dementia a possibility during mid-life, and they put down symptoms like memory loss to stress.
(The author, a former editor of 'Health & Nutrition' magazine, works as a counseling therapist)