The Controversy Surrounding Mental Illness

A great deal of controversy and mystery surrounds the treatment of clinical depression, utilizing both medications and electroconvulsive therapy as indicated for medication-resistant or intractable depression, and the discrimination that those who receive this treatment experience. This topic is of special interest to me both professionally, as a psychiatric nurse, and personally, as I have suffered from bipolar affective disorder and related episodes of depression since early adulthood. Our society continues to stigmatize those who experience mental illness in ways that individuals who develop other medical conditions are exempt from, and this viewpoint has an impact on the treatment of depression as well. The negative connotations of mental illness or depression can inhibit the sufferer from seeking the appropriate treatment, or from disclosing the existence of their condition which can then further complicate their daily existence.

At the same time that our society places stigma against depression, we have come to use the term in common language in a way that does a disservice to those who are experiencing true clinical depression. Students may say they are “depressed” because an assignment is particularly challenging, employees may say they are “depressed” because they have to work on a holiday weekend, but this use of the word to indicate displeasure is grossly inaccurate. By describing dissatisfaction as depression, we fail to do justice to what true clinical depression can be, and thus make false judgments against those who do seek treatment, basing their situation on our own terminology.

 The symptoms of clinical depression vary with each individual, and may also very in severity over the course of a period of illness or over the course of an individual’s lifetime, much like any other medical disease. For example, my illness today makes it difficult for me to think clearly, or to complete normal tasks of daily living without feeling like I am trudging through a swimming pool filled with jello, and yet if my symptoms were related to diabetes or heart disease there would be no fear of disclosing them.

 Not everyone understands how a diagnosis of a mental illness is made, and this further substantiates my belief that we need to provide greater education to the general public in order to alleviate the fear of the unknown that is often associated with mental illness.There is a tendency within our society to “see mentally ill people as a group that should be hidden away so that no one has to deal with it”. The fear of speaking up about the issue of mental illness does play a role, in spite of the fact that mental illness, in one form or another, affects such a high percentage of the population. ion, we have come to use the term in common language in a way that does a disservice to those who suffer from a true mental illness or a clinical depression.

Two major controversies related to clinical depression and other mental illnesses are the actual treatment that is provided, and preventing the limiting of medical benefits for the treatment of mental illness, or the “health care parity” issue, and the issue of stigma and discrimination itself. For instance, someone who is diagnosed with Bipolar disorder becomes ineligible for standard health or life insurance, without regard to the severity of their illness or any treatment outcomes. Most employment applications ask if a prospective employee has ever been diagnosed or treated for a major mental illness, right before they ask if the applicant has been convicted of a felony. Additionally, there is a growing contingency of “antipsychiatry advocates” who feel that they have been mistreated by the psychiatric treatment community, and are opposed to all psychiatric treatment as a matter of principle, which further clouds the issue for those who are uneducated about mental illness.

I believe that mental illness should be treated with all available technological and medical advances as any other debilitating or life threatening condition, and that scientific research should continue on a par with that for every other disease process. I am vehemently opposed to the stigmatization of those with neurobiological disorders, and believe that with appropriate treatment, many individuals who suffer from these disorders manage to live extremely productive lives and are worthy of the same care and respect that those with chronic heart disease are entitled to. The fact that I have been dependent on medication for the past 30 years to control the neurotransmitters in my brain does not make me less valued as a person than someone who requires insulin to control the level of sugar in their bloodstream, nor should I be ineligible for opportunities that anyone else is entitled to.

It is the negative stigma that often prevents individuals from seeking the appropriate treatment for their symptoms of mental illness, such as depression. Fears of being labeled may result in a person seeking some care, such as contacting their primary care physician for a trial of antidepressant medication, but in the event that this is inadequate the patient is often reluctant to be identified as in need of psychiatric specialized care.

While I am a mental health care professional, a certified Psychiatric Nurse, a Certified Addictions Counselor, I too am subject to concerns about being identified as having a mental illness, and that even now, as I am currently struggling with a depressive episode that is requiring significant medication adjustments, making me unable to work, I worry that this may affect my credibility on the job when I am able to return to work.

Mental illness, which affects a significant portion of the American population, is often untreated,  or under-treated due to patient’s fear of being stigmatized and identified as being mentally ill, and this issue which has tremendous social and economical impact can be improved by the appropriate widespread education of our society and anti-stigma programs.

One major controversy that relates to mental illness is the treatment of mental illness itself, its financing and availability, public perception of treatment, and misunderstandings among the general public about such issues as psychotropic medications and how they impact patients, and other treatment options such as electroconvulsive or shock therapy. The increasing negative media coverage of both the mentally ill, and the treatment of the mentally ill, which tends to change based upon current events, such as the recent Virginia Tech tragedy, has an impact on the stigmatization of the mentally ill. On the one hand, society would like to forget that the issue exists, and on the other, they are angered that more isn’t done to prevent such tragic occurrences. At the same time, an incident such as the murders of innocent people by a mentally ill person do much to continue the negative feelings about the mentally ill, when in fact the majority of people who suffer from a mental illness are a much greater risk to themselves then they ever are to anyone else.