Confronting the Stigmas and Fears of Mental Illness

Today anyone who suffers from mental illness probably knows the pain and loneliness of being shunned and ostracized, as if they were condemned to wear permanent scarlet letters, only this time the letters being “C” for crazy, “F” for freak, “P” for psycho, and so on.  Often, these patients feel as though they must keep their illnesses secret, for if the world discovers they will be condemned to a lesser status, seen as weak, unworthy, as losers in the race of the survival of the fittest.

But we are losing our privacy more and more by the day, including our right to have certain information stay secret.  This is especially true with mental illness, with the ever present link between mental disorders and gun violence.  It is entirely appropriate that if someone wants to buy a gun, their mental health should be under scrutiny.  But if someone’s mental illness becomes public, they are inevitably subjected to humiliation and rejection.

Part of the problem about our society’s attitude toward mental illness is fear.  As physicist and chemist Marie Curie once said, “Nothing in life is to be feared, it is only to be understood.  Now is the time to understand more, so that we may fear less.”  If our entire society put this philosophy into practice when considering mental illness, we would probably not fear it as we do.  But how often is the average citizen educated about these matters?  How often do school health or physical education classes even touch these subjects?  Too often mental illness is seen as taboo; untouchable; unfit for student consumption in this our nanny state.

Additionally, the human brain is not easy to understand.  In certain instances, the experts cannot even agree on what mental illness is.  In November 2012, just weeks before the massacre at Sandy Hook Elementary, a New York Times article described how mental health experts cannot even agree on official definitions for personality disorders.  The article describes those with personality disorders as “orphans and outliers, a colony of misfit characters on their own island: the bizarre one and the needy one, the untrusting and the crooked, the grandiose and the cowardly.”  And this is how even an enlightened, educated New York Times reporter describes mental health patients – as pariahs, untouchables – in an article ostensibly designed to create more awareness about them.

Mental health experts could not agree on definitions for personality disorders so that these illnesses could be included in the Diagnostic and Statistical Manual of Mental Disorders (“DSM”).  In the 1970s, scientific director of the Institute for Advanced Studies in Personology and Psychopathology Ted Millon formulated a set of 10 standardized types of personality disorders, which was included in the 1980 edition of the DSM.  Dr. Millon’s contributions to the DSM led to improved treatment for these illnesses, including borderline personality disorder, which is “characterized by an extreme neediness and urges to harm oneself, often including thoughts of suicide,” and which renders patients “resistant to the usual therapies, like antidepressant drugs.”

However, many experts called for a re-write of the DSM to incorporate personality disorders that don’t fall neatly into one category but which combine characteristics of multiple conditions.  But agreeing on definitions for this re-write turned out to be a convoluted and heated battle.  Many experts could not agree – some “argued that throwing out existing definitions was premature and reckless. Others insisted that the diagnoses could not be simplified so much. And some complained that the effort to anchor the disorders in traits had not gone far enough.”

Thomas Widiger, a professor of psychology at the University of Kentucky, compared the debacle to “the parable of the six blind men from Hindustan, each touching different parts of the elephant,” in which “[e]veryone’s working independently, and each has their perspective, their own theory..It’s a mess.”  Dr. Millon denounced the deadlock among experts, saying “It’s embarrassing to see where we’re at. We’ve been caught up in digression after digression, and nobody can agree..It’s time to go back to the beginning, to Darwin, and build a logical structure based on universal principles of evolution.”

There are many aspects about how the brain functions that even today we do not know or understand and that terrifies many people.  In the age of the new Tower of Babel, even as many people scramble to build this tower, believing they are omniscient, virtually gods themselves, they cannot avoid the reality that there are still too many things they do not know and a complete understanding of how the brain works is one of them.

So too many times, instead of admitting what we don’t know and embracing the learning process, we cowardly turn toward that which we do know – control, power and suppression, particularly if we hold a position of authority.  We seek to suppress, control or dismiss mental illness.  We label those with mental illness crazy, sometimes denying professional licenses to those who are otherwise qualified and can perform the job. 

Take the legal profession, for example.  Lawyers are required to show the board of bar examiners that they possess the “requisite fitness and moral character for the practice of law.”  On its face, this rule makes sense.  Of course you want to have an attorney of sound mind and morals, for these qualities are central to attorneys’ duties and ethical responsibilities.  But how do these mental health requirements actually play out? 

The legal profession in general still carries a poor reputation, because of the overabundance of unscrupulous lawyers.  Those lawyers who suffer from mental illness but are responsible about it, get treatment when necessary and put their responsibilities first are a world apart from unethical attorneys who give the profession a bad name and who are intentionally unscrupulous.  Why are those attorneys not singled out? 

On the contrary, attorneys are sometimes seen as more accomplished if they are overly aggressive, deceptive, duplicitous, and antagonistic.  Such attorneys are even celebrated because such behavior is often equated with strength – power through intimidation, hardball, mud-slinging, etc.  Since mental illness is frequently viewed as weakness, attorneys suffering from these afflictions are often viewed as more unfit to practice law than those who break ethical rules with impunity.

Many bar applications require candidates to disclose not just severe mental illnesses such as schizophrenia and psychotic disorders but also whether the applicant has so much as been treated for depression.  Candidates have also been singled out for having bipolar disorders, a vacuous term which has come into vogue as a catch-all for mental illness in general, without regard for the term’s true meaning.  A Harvard Law graduate who was already admitted to the New York and Massachusetts bars applied was initially denied admission to the Connecticut bar following her timely disclosure that she suffered from bipolar disorder.  She was then subjected to a year-long hearing process which even led one of the examiners to describe as “torture.”  And after all this, the most she could obtain was conditional admission under which she was required to submit a doctor’s report and affidavit semiannually for nine years.

So even the supposed lofty and erudite legal community is not immune from misconceptions and stereotypes about mental illness.  Of course, patients should take accountability for their condition and recognize when it is incumbent on them to get help.  But they are greater than fearful stereotypes.  They can lead fulfilling, productive lives just like others who happen to live with diseases.