Does mental illness as a stigma lead to under-diagnoses and further health risks?

Here’s a disclaimer to start: I don’t have much personal experience with people with mental illnesses or disabilities, so this post will focus more on what I have heard second-hand from friends and family, from studies on the topic, and how mental illnesses are portrayed in the media. The reason I chose the topic of mental illnesses is actually because of how little I ever hear about them spoken aloud or discussed, even though around 44 million adults – nearly 14% of the U.S. population – experience a mental illness in a year. As many as half of that total can go undiagnosed or receive limited or improper treatment. Despite this, in my opinion, there is a severe lack of common knowledge of mental illnesses, and there remains several negative disordersstigmas that can lead people ignore their illness and potentially negatively impact their health.

A stigma is a belief that can be associated with a person or quality that carries a negative connotation. There are many stigmas surrounding mental illnesses, though the most common beliefs are that people with mental illnesses are violent, that being diagnosed makes a person appear weak or undesirable to significant others and employers, and that people with mental illnesses have childlike tendencies. But how can stigmas affect a person’s mental wellbeing? Well, based on an article in Schizophrenia Bulletin, while stigmas are beliefs that are developed by the public, who do not fully comprehend the object of the stigma’s interest, they are also affected by the reaction of the minority group the stigma is labeled toward. It tends to be that when those the stigma crudely represents hear of the misconceptions, they react in ways they normally would not. For example, if someone with a mental illness were to hear a stigma that someone with their disorder is violent and dangerous, a natural reaction would be for them to become angry at the person they hear it from. However, in most cases this reaction does nothing to stave off the stigma, but rather reinforces it, although unfairly. The most common emotion upon hearing a stigma surrounding something they suffer from is shame, as people tend to be embarrassed when they find out what others think of them but have no way or motivation to disprove them. Stigmas only further to separate the general public from the minority group, leading to a sense of alienation and loss of social status, thus leading to more stigmas, such as claiming that sillopeople with mental illnesses are socially inept or unable to function properly.

The impact these stigmas have on the public and on those with mental illnesses is immense; some of the public will refuse to help those with an illness, others avoid them entirely, and friends or family can push their loved one into an unwanted treatment that may lead to damaging the relationships between them. Not only is there a public stigma on mental illness, but because of the beliefs of people around them, sufferers of mental illnesses may begin to internalize their own self-stigma. They may start believing that they are less valued than a person without a mental illness, lowering their self-confidence and self-esteem. Depressive disorders especially heighten these feelings, as the person may already have seen themselves in a negative light to begin with.

While stigma is mostly conceptual rather than scientifically factual, making it a soft science rather than hard science, there are some areas of science that can be brought in for this argument. For example, a study in 1998 in the Journal of Affective Disorders researched whether or not bipolar disorder was under-diagnosed and anti-depressants were being over-utilized as a treatment method. Studying hospital records, the report found that most patients had not been correctly diagnosed – or diagnosed at all – in the past, and most were given anti-depressants as treatment, rather than mood-stabilizers. For patients who had been incorrectly diagnosed with antidisorders other than bipolar disorder, an average of 7.5 years passed until they were correctly diagnosed and treated. This study helps show that modern understandings of mental illnesses, even when an attempt is made at diagnosing and treating, is severely lacking. Although this study does not explicitly state that the health of people that were under-diagnosed became worse, it can be assumed that the misdiagnoses and wrong treatment method was not beneficial.

Some people might argue that it is the 21st century, and there is always room for improvement, which I readily agree with. While many representations of mental illnesses in media are unsavory or inaccurate, there have been some more recent positive portrayals that shine a light on what people with these disorders go through, and at the same time showing that they can live normal lives, just like everyone else, just with different hurdles to jump over. Internet and social media allows people to share their experiences, allowing for the first time for people to see the extent of mental illnesses and to have a community. However, improvement, especially in this area, is not always natural and need a catalyst or starting place, which in this case I believe is middle and high schools. Curriculum on disorders should be added to health classes, and people of all ages should be encouraged to integrate mental checkups in with annual physicals. It is my belief that stigma should be replaced with the truth, so that people can begin receiving treatment without feeling shameful or wanting to hide their illness, as that can only lead to further deterioration of their health.

Sources:

US Stats: http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

World Stats: http://www.iccd.org/keyfacts.html#young

About Stigmas: http://www.waisman.wisc.edu/EVENTS/ethics/Corrigan_Stigma_WP_2002.pdf

Measuring Stigma: http://schizophreniabulletin.oxfordjournals.org/content/30/3/511.full.pdf+html

Bipolar Study: http://www.sciencedirect.com/science/article/pii/S0165032798000767

Negative TV: http://www.vulture.com/2016/09/what-tv-gets-wrong-about-mental-illness.html

Positive TV: http://www.much.com/5-tv-shows-that-got-mental-health-right/

Pictures:

Disorders: https://www.exposingtruth.com/wp-content/uploads/2016/06/mentalhealth.jpg

Silhouette: http://assets.rappler.com/612F469A6EA84F6BAE882D2B94A4B421/img/B4B996E452134695B7A2636932B88EDC/depressed-man-20130323-rappler_8fc9bc92b2a347b4a03c5234cda1f9fb.jpg

Antidepressants: http://www.newhealthadvisor.com/images/1HT18076/antidepressants.jpg

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