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a Continual learning process
Suzy reckons having a psychiatric condition must be seen as a continual learning process.
Personally as someone who started off just as a carer/mum and now campaigns for maintaining services or even improving them with the health services and politicians involved as well as supporting friends who have vulnerable mental health, it appears to be that the more I learn the less I seem to know.
JJ
www.thecairn.com
Suzy reckons having a psychiatric condition must be seen as a continual learning process.
Personally as someone who started off just as a carer/mum and now campaigns for maintaining services or even improving them with the health services and politicians involved as well as supporting friends who have vulnerable mental health, it appears to be that the more I learn the less I seem to know.
JJ
www.thecairn.com
David Baxter PhD
Late Founder
HA
Member
The many stigmas of mental illness
The many stigmas of mental illness
(Essay Focus) Kay Redfield Jamison
The Lancet, Feb 11, 2006 v367 i9509 p533(2)
Much of the stigma of mental illness is engrained in deep and ancient attitudes held by virtually every society on earth. These attitudes govern the decisions societies make and the behaviours they tolerate. Newspapers and television stations can print or broadcast statements about those with mental illness that simply would not be tolerated if they were said about any other minority group. Stigma also insinuates itself into policy decisions, access to care, health insurance, employment discrimination, and in research allocations and priorities. Unfortunately, people who have mental illness also stigmatise themselves. They make few demands and their expectations are frighteningly low--with grave consequences. Stigma can kill.
The inability to discuss mental illness in an informed and straightforward way, to deal with it as the major public health concern that it is, is unjustifiable. There is a very large group that I think of as the silent successful--people who get well from psychiatric illness but who are afraid to speak out. This reluctance is very understandable, very human, but it is unfortunate because it perpetuates the misperception that mental illness cannot be treated. What remains visible in the public eye are the newspaper accounts of violence, the homeless mentally ill, the untreated illness in friends, family, and colleagues. What is not seen are all the truck drivers, secretaries, teachers, lawyers, physicians, and government officials who have been successfully treated, who work, compete, and succeed.
My own perspective on stigma is shaped not only by being a professional who studies mental illness but as someone who has suffered from manic depression since I was 16 years old. I strongly believe that we need to better understand why stigma exists, and not just from a sociological or anthropological point of view. Studies of animal behaviour make it very clear that animals discriminate not only against those who are markedly odd, but also against those who are different in more subtle ways. I believe that the expression of stigma or discrimination is deep-wired into the brain. There are good reasons for fear, which have to do with the unknown, the unpredictable, and the potentially violent. We have to acknowledge upfront that untreated mental illnesses can be frightening and that it can be associated with violent acts. Indeed, we know from many studies that 50% of manic episodes are characterised by at least one act of physical violence. We also know that moods are contagious. Hypomania and depression can spread across members of a group like wildfire. That is, in part, what moods are for--to affect others in a group. So we have to acknowledge that mental illness can have a powerful effect on those close to it.
Second, I believe that research is the greatest destigmatiser. We need to get people interested in the brain, and in the fact that these are very interesting illnesses. We need to capture the imaginations of the young and explain that understanding the brain is the last great frontier. To make an illness interesting is to some extent to help destigmatise it.
Third, we need to start within our own clinical community and have more honest and open discussions about impaired doctors, psychologists, and nurses. Unless we are willing to talk about how to deal with mental illness among professionals the problem is going to remain undiscussed, creating more fear and more stigmatisation. We also need to standardise the teaching of the clinical science underlying these illnesses. Some of the stigma associated with mental illness exists because there has been so much bad teaching and inadequate treatment over the years.
We also need to recognise that those of us who have mental illnesses represent a very large block of voters. If you look at the numbers, we have not advocated well. We have not used the political power we have. We need better public awareness campaigns. Public perception about mental illness lags decades behind the science. We need to convey how real and extensive our scientific understanding is, the effectiveness of existing treatments, and the promise research holds for the future.
The stigma that those with psychiatric illness face is only truly understood by those who have been on the receiving end of it. This became more painfully clear to me when I wrote a book, An Unquiet Mind, (1) that recounted my own experience with manic-depressive illness.
I received thousands of letters from people. Most of them were supportive but many were exceedingly hostile. A striking number said that I deserved my illness because I was insufficiently Christian and that the devil had gotten hold of me. More prayer, not medication, was the only answer. Others were irate that I had continued my professional work, even though my illness was well-controlled. The most upsetting letters, however, were from doctors, psychologists, and nurses who wrote about their own mood disorders, suicide attempts, and substance misuse problems. All made the irrefutable point that it was disingenuous for hospitals and medical schools to expect health-care professionals to be straightforward about mental illness when their hospital privileges, referral sources, and licences to practice were on the line. This is undeniably true.
The chairmen of my academic departments have been compassionate and supportive of my career. I am fortunate in this regard; most others in my situation are not. Mental illness is as least as common in our colleagues as it is in the general public, which is to say it is common. Suicide occurs far too often. We need to reach out to our colleagues. As mentors and educators we need to be proactive, we need to educate medical students, house staff, and graduate students about depression and other mental illnesses. We need to make it easy for them to get treatment. We need as well to educate them more effectively about how best to diagnose and treat mental illness in their patients. We as a profession also need to reach out to society to say that we will not tolerate the kind of pain and discrimination that has gone on for far too long.
When I wrote my book I had no idea what the long-term consequences of being public about my manicdepressive illness would be. I assumed that they were bound to be better than continuing to be silent. I was tired of hiding and tired of the hypocrisy. I was tired of being held hostage to stigma and tired of perpetuating it. Now there is indeed no turning back and I find myself continuing to take solace in Robert Lowell's question, the one which had been at the heart of my decision to be public about my illness: "Yet why not say what happened?"
Department of Psychiatry and Behavioural Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA (Prof K R Jamison PhD)
The many stigmas of mental illness
(Essay Focus) Kay Redfield Jamison
The Lancet, Feb 11, 2006 v367 i9509 p533(2)
Much of the stigma of mental illness is engrained in deep and ancient attitudes held by virtually every society on earth. These attitudes govern the decisions societies make and the behaviours they tolerate. Newspapers and television stations can print or broadcast statements about those with mental illness that simply would not be tolerated if they were said about any other minority group. Stigma also insinuates itself into policy decisions, access to care, health insurance, employment discrimination, and in research allocations and priorities. Unfortunately, people who have mental illness also stigmatise themselves. They make few demands and their expectations are frighteningly low--with grave consequences. Stigma can kill.
The inability to discuss mental illness in an informed and straightforward way, to deal with it as the major public health concern that it is, is unjustifiable. There is a very large group that I think of as the silent successful--people who get well from psychiatric illness but who are afraid to speak out. This reluctance is very understandable, very human, but it is unfortunate because it perpetuates the misperception that mental illness cannot be treated. What remains visible in the public eye are the newspaper accounts of violence, the homeless mentally ill, the untreated illness in friends, family, and colleagues. What is not seen are all the truck drivers, secretaries, teachers, lawyers, physicians, and government officials who have been successfully treated, who work, compete, and succeed.
My own perspective on stigma is shaped not only by being a professional who studies mental illness but as someone who has suffered from manic depression since I was 16 years old. I strongly believe that we need to better understand why stigma exists, and not just from a sociological or anthropological point of view. Studies of animal behaviour make it very clear that animals discriminate not only against those who are markedly odd, but also against those who are different in more subtle ways. I believe that the expression of stigma or discrimination is deep-wired into the brain. There are good reasons for fear, which have to do with the unknown, the unpredictable, and the potentially violent. We have to acknowledge upfront that untreated mental illnesses can be frightening and that it can be associated with violent acts. Indeed, we know from many studies that 50% of manic episodes are characterised by at least one act of physical violence. We also know that moods are contagious. Hypomania and depression can spread across members of a group like wildfire. That is, in part, what moods are for--to affect others in a group. So we have to acknowledge that mental illness can have a powerful effect on those close to it.
Second, I believe that research is the greatest destigmatiser. We need to get people interested in the brain, and in the fact that these are very interesting illnesses. We need to capture the imaginations of the young and explain that understanding the brain is the last great frontier. To make an illness interesting is to some extent to help destigmatise it.
Third, we need to start within our own clinical community and have more honest and open discussions about impaired doctors, psychologists, and nurses. Unless we are willing to talk about how to deal with mental illness among professionals the problem is going to remain undiscussed, creating more fear and more stigmatisation. We also need to standardise the teaching of the clinical science underlying these illnesses. Some of the stigma associated with mental illness exists because there has been so much bad teaching and inadequate treatment over the years.
We also need to recognise that those of us who have mental illnesses represent a very large block of voters. If you look at the numbers, we have not advocated well. We have not used the political power we have. We need better public awareness campaigns. Public perception about mental illness lags decades behind the science. We need to convey how real and extensive our scientific understanding is, the effectiveness of existing treatments, and the promise research holds for the future.
The stigma that those with psychiatric illness face is only truly understood by those who have been on the receiving end of it. This became more painfully clear to me when I wrote a book, An Unquiet Mind, (1) that recounted my own experience with manic-depressive illness.
I received thousands of letters from people. Most of them were supportive but many were exceedingly hostile. A striking number said that I deserved my illness because I was insufficiently Christian and that the devil had gotten hold of me. More prayer, not medication, was the only answer. Others were irate that I had continued my professional work, even though my illness was well-controlled. The most upsetting letters, however, were from doctors, psychologists, and nurses who wrote about their own mood disorders, suicide attempts, and substance misuse problems. All made the irrefutable point that it was disingenuous for hospitals and medical schools to expect health-care professionals to be straightforward about mental illness when their hospital privileges, referral sources, and licences to practice were on the line. This is undeniably true.
The chairmen of my academic departments have been compassionate and supportive of my career. I am fortunate in this regard; most others in my situation are not. Mental illness is as least as common in our colleagues as it is in the general public, which is to say it is common. Suicide occurs far too often. We need to reach out to our colleagues. As mentors and educators we need to be proactive, we need to educate medical students, house staff, and graduate students about depression and other mental illnesses. We need to make it easy for them to get treatment. We need as well to educate them more effectively about how best to diagnose and treat mental illness in their patients. We as a profession also need to reach out to society to say that we will not tolerate the kind of pain and discrimination that has gone on for far too long.
When I wrote my book I had no idea what the long-term consequences of being public about my manicdepressive illness would be. I assumed that they were bound to be better than continuing to be silent. I was tired of hiding and tired of the hypocrisy. I was tired of being held hostage to stigma and tired of perpetuating it. Now there is indeed no turning back and I find myself continuing to take solace in Robert Lowell's question, the one which had been at the heart of my decision to be public about my illness: "Yet why not say what happened?"
Department of Psychiatry and Behavioural Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA (Prof K R Jamison PhD)
Cat Dancer
MVP
I was watching a movie and one of the characters said something like, "The quickest way to shut someone up is to call them crazy." And I was thinking I've kind of felt this way for a long time. That my thoughts and feelings and opinions don't matter to anyone because I'm "crazy." And how even though words shouldn't hurt us, they do hurt. And how some people can be so cruel.
But on the other hand, I was thinking there are many wonderful, caring people in the world who don't use those words to hurt. And there ARE compassionate people who can help you see that you do matter and that your thoughts matter and your feelings aren't stupid.
But on the other hand, I was thinking there are many wonderful, caring people in the world who don't use those words to hurt. And there ARE compassionate people who can help you see that you do matter and that your thoughts matter and your feelings aren't stupid.
Cat Dancer
MVP
That is true, nsa. 
I know for me, it's really hard to believe I deserve anything good. It's very hard. Right now anyway. I really hope I can work through all of this in therapy.
I know for me, it's really hard to believe I deserve anything good. It's very hard. Right now anyway. I really hope I can work through all of this in therapy.
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