Even in 2014, after decades of progress in understanding and treating mental illness, disorders like depression, bipolar and schizophrenia still come with a stigma that doesn’t attach to other diseases.
The stigma issue has arisen anew this month, with a new twist, in an article titled “The Unconscionable Gap Between What We Know and What We Do” by Dr. Steven E. Hyman of the Stanley Center for Psychiatric Research at Harvard. Writing in the journal Science Translational Medicine, Hyman asserts that “treatment of mental disorders remains a low priority worldwide – disproportionately so in low- and middle-income countries.”
But Hyman goes a step beyond the stigma argument and suggests that policy makers and others may not consider mental illness to be a real disease, that the mentally ill can simply think their disorders into submission.
“(This) powerful cognitive distortion also plays a role in the deprioritization of mental illness: the belief that mental disorders should somehow be controllable, if only the affected person tried hard enough or adhered to a better set of beliefs,” he writes.
Driving that notion is our misconception that we understand why we do what we do.
“We generally believe we have transparent insight into the reasons behind our choices and actions,” says Hyman. “In fact, nearly the entire weight of modern cognitive neuroscience argues that this belief is illusory and that the underlying mechanisms of thought, emotion and behavior are largely, if not entirely, opaque to us.”
Bill Gardner, writing in the Incidental Economist blog Saturday, applauds Stevens’ essay and elaborates on our inability to understand our thoughts and emotions. Gardner talks about a “person with obsessive compulsive disorder who has to check the stove 20 times to make sure it’s really turned off, wash your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
"And they have to do these things even though they know it's crazy," Gardner says. "You will see that these people are overwhelmed by mental processes they cannot control and that they are not responsible for their distress."
The stigma attaching to mental illness leads to all kinds of harmful effects, says the Mayo Clinic. The clinic's website lists these consequences:
- Reluctance to seek help or treatment
- Lack of understanding by family, friends, co-workers or others you know
- Fewer opportunities for work, school or social activities or trouble finding housing
- Bullying, physical violence or harassment
- Health insurance that doesn't adequately cover your mental illness treatment
- The belief that you'll never be able to succeed at certain challenges or that you can't improve your situation
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