Stigma. Not a pleasant word.
Oxford Dictionary defines stigma as “a mark of disgrace associated with a particular circumstance, quality or person.”
Synonyms include shame, disgrace, dishonor, stain, taint, blemish, mark, slur.
Powerful words with little room for misinterpretation.
Now think of mental health. Why all the stigma?
Frankly, a lot of it begins at home – often with families not aware of the stigma they are piling on top of stigma. I call it subtle stigma.
Why can’t you be like your brother?
You’re not trying hard enough.
Please don’t embarrass our family again.
Children eventually believe all that they hear.
I am a problem.
Or a phrase that one of my children coined years ago.
I feel like an extra. I don’t know where I belong.
Before we quickly blame families and stigmatize them too, let’s look at the reality of mental health.
Part of the dilemma lies with the abstract nature of mental health. Hard to wrap logic around it – because mental health involves mysteries within the brain and appears invisible on the surface.
Although the words “mental health” are used extensively these days in a variety of circles, what the heck do those “two words” actually mean?
To the listener – and the individual who’s affected.
For starters, mental health involves a subjective diagnosis. Not an objective one – like a blood test to pinpoint a specific disease. Even two psychiatrists don’t necessarily speak the same language about the same person.
Thus, opinions on the actual condition vary widely. And they’re not always positive from family and friends.
What’s wrong with you? Knock it off.
Stop being so weird.
I don’t want to be around a person who acts like you.
The result. Paralyzing stigma.
Over time many individuals with mental health challenges expect people to treat them like second class citizens. With little to no voice, they respond accordingly.
That’s why they isolate.
That’s why they avoid situations.
That’s why they refuse to communicate.
In my own space, I can be me. Authentic. Not someone’s vision of me.
Yet – how does the average person in society respond to this unique behavior?
Rather than shifting their approach to further understand mental health, he or she throws up their hands and walks away. Some even pontificate, “I have a choice and I choose to eliminate negative people from my life.”
Without second thoughts.
No wonder my children – and many like them with similar mental health histories – had few friends growing up. And few today as young adults.
What about that mental health diagnosis? Is it a blessing or a curse?
Mis-diagnoses. Under-diagnoses. Over-diagnoses. How many labels can be attached to one individual?
Fact is most people roll their eyes when parents rattles off a list of a half a dozen fancy names to describe their children’s behavior.
Judgment rather than empathy.
Furthermore, some psychiatrists hand out extremely negative labels with minimal patient history. You heard that right.
Does a diagnosis of Oppositional Defiant Disorder or Conduct Disorder actually help? Among educators and juvenile justice professionals, it generates an immediate reaction.
Hopeless. Devoid of hope. Since the situation won’t improve, why bother?
Another throw-away kid.
Stigma on steroids.
Forgetting that the individual is more than a diagnosis.
Creating perceptions that can follow a person for life.
Adding confusing and conflicting information.
Why is a physical health diagnosis and a mental health diagnosis not treated equally?
For people with mental health challenges, they could benefit from kind words and a sense of inclusion. They often receive neither – even following a new, debilitating diagnosis.
Meanwhile, people with a physical health challenge receive the exact opposite reaction. An outpouring of support. Offers of casseroles, car rides and personal assistance.
You can beat this.
We’re here for you.
Mental health stigma. Alive and well every day.
Sadly, too, seeking professional help isn’t stigma free.
One size fits all.
Lack of evidence-based family therapy.
Lack of in-patient treatment beds.
Lack of holistic psychiatrists, especially those who “do more” than simply prescribe medication.
Now back to the family role in stigmatizing.
It’s huge – because many people with mental health conditions spend more time with their families than any other group.
In other words, word choice matters. So does a positive voice and tone to reduce the effects of prior stigma.
Once we finish cleaning your bedroom, we’ll have lunch.
On the other hand, negative statement can easily escalate into an argument – one that no one wins.
If you don’t clean your bedroom right now, I’m not making you lunch.
Ultimatums may work the first time – but rarely after that. In fact, I could say ultimatums are the ultimate trust buster.
My daughter taught me a valuable lesson years ago. She didn’t mince words.
You are my worst trigger.
She was right. To this day I’ve never forgotten her blunt message. Yet I was man enough to accept the truth.
Therefore, I try my best every day to use my “position of influence” to connect with my children.
Instead of showing my frustration.
Instead of talking down to them.
Instead of creating unattainable benchmarks.
Instead of pushing them out of my life.
Stigmatizing them further.
At the same time, stop calling people mentally ill. They are not ill. This isn’t a bad case of the flu where someone wants to be left alone and sleep. Waking several days later refreshed. Thankful the worst is over.
People with serious mental health conditions have a chronic condition.
But that condition can be managed in a variety of ways.
- regular access to family and peer support
- daily activities reinforcing self-worth
- the right – not just any – therapy
- self-care including diet and exercise
- psychotropic medication which should always be the last resort.
Note that I put family and peer support first – because it matters most.
But don’t become complacent. Mental health symptoms will come and go. And when they return, leave stigma at the doorstep. A heavy dose of judgment quickly fuels a downward spiral.
In stigma’s place, be mindful. Listen. Offer perspective. Never overstep and assume you know more.
Your gentle and timely approach makes a difference. More than you realize.
Please, no stigma today. DCP
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