When I told my friends and family I was writing this column, all I received was unwavering support. Even my dad, ever-private and reserved, encouraged me to write it. My parents weren’t raised in a culture that talked about mental illness, but after watching me suffer, enter treatment and then advocate for mental health services — they see that mental illness is not shameful. Talking about it brings us closer. We’ve been able to reach a place where we agree it’s vital to talk about.
Mental health has finally come into public consciousness, and it seems like everyone’s talking about it. A recent classmate commented on Facebook that stigma against mental health isn’t a problem anymore, and that PTSD isn’t a real illness. I have friends who read my writing and tell me they’re proud of me, only to later admit they believe depressed people should just be trying harder. This makes me feel like they haven’t heard me at all.
Stigma hasn’t gone away. It’s just more insidious.
There is a limit to what is “acceptable” when it comes to having a mental illness. Depression and anxiety are more common and understandable. When my therapist, psychiatrist and I discussed whether I might have bipolar disorder, at first the diagnosis was devastating. I worried people would think differently about me if I had a less “acceptable” illness, one stereotyped by wild mood swings and erratic behavior.
In reality, bipolar disorder is similar to depression, and isn’t necessarily severe or unpredictable. My mood shifts are so mild and so infrequent that we haven’t been able to determine if I have a mild form of bipolar disorder, or if I’m just depressed and have mood swings. The line is blurry.
I am nervous to tell people I take antipsychotics, and always mention that I don’t actually have psychosis — I take them as an adjunct to my antidepressant to boost its effects. I wish I didn’t feel the need to insist that fact, but I worry others will back away from me if they think I’m “crazy.” When I told a friend of mine, she jokingly jumped back, eyes wide and asked, “Are you gonna go crazy on me?” Although it was a joke, it still hurt my feelings. Even if I did have psychosis, I would hope they wouldn’t fear me, or see me differently if I suffered from an uncommon symptom.
The stigma extends past diagnosis and into treatment. I’ve had many conversations with people who don’t have a mental illness, but have a list of recommendations ready as if they have a medical degree. When I say I have depression, people almost always ask, “Are you exercising?” Please take my word when I say exercise is not the solution to my chronic, deeply rooted and multifaceted mental illness. Going to the gym has not, to my surprise, dramatically altered my brain chemistry.
It makes sense that a friend’s first response would be to try helping me. When people I love suggest trying diets, exercising, praying, taking vitamins, crystals, lifting a curse that might’ve been put on me or just willing myself out of it, it feels less like help — and more like judgment and contempt. It’s not to say those things don’t help (my therapist loves crystals), but imposing solutions on me implies that my decision to try conventional forms of treatment, like therapy and medication, are poor choices. I’ve dedicated all my time and energy trying to treat my illness, but these friends don’t see how hard I’m trying and think I’m not working hard enough.
This happens especially when I tell people I’m on medication. People never hesitate to remind me of all their preconceptions about how it negatively impacts long-term health, and how it has horrible side effects. After trying eight medications, I know this well. And I also know that trying medication is worth it, that it has allowed me to function and do all the other things everyone demands of me.
I know that friends and acquaintances are well-meaning, and their advice is clouded by misconceptions. I’m learning how to gently let people know if they hurt my feelings, and not consider myself too sensitive. If I let others believe that depressed people aren’t trying hard enough, I might start believing that about myself. But I do believe that it’s everyone’s responsibility to rid themselves of stigma, instead of just relying on the sick to educate and correct. I hope my friends make an effort to really understand what I’m going through — just as I would do for them.
My most helpful friends are the friends who are just present. They let me be as I am, illness included. They comfort me on my bad days and celebrate my good ones. They simply ask, “What can I do to help?” Suggestions have their place, if someone asks for them. But perhaps a good place to start is to just have compassion for each other.