Stigma of Mental Illness- Based on Fact or Fiction?

From the Merriam Webster Dictionary

Definition of stigma

plural 

stigmata

play\stig-ˈmä-tə, ˈstig-mə-tə\ or 

stigmas

1. 1a archaic :  a scar left by a hot iron :  brandb :  a mark of shame or discredit :  stain bore the stigma of cowardicec :  an identifying mark or characteristic; specifically :  a specific diagnostic sign of a disease

People can and do make negative judgments about others who have mental health diagnoses.

But, is it warranted? Well, in my experience, it's complicated.

The biggest issue I have run into is that I am treated like a textbook diagnosis list from the DSM-5 when I admit any of my diagnoses.

Why is that a problem? I have been diagnosed as having it, so they should be allowed to jump to that idea, right?

Well, no. I do not think the same way, or behave the same way as an untreated freshly diagnosed person with the same condition. 

Also, most illnesses in the DSM-5 only require a certain number of characteristics from a list to be present for diagnosis. That means you could meet 2 people with the exact same mental health label, who present their symptoms slightly differently even before treatment begins. 

There is also the level of severity to consider. One person's symptoms may be mild enough that it isn't usually noticed, another person's symptoms may be so intense and observable that it draws attention.

Think about this: Should a person who isn't currently following their treatment plan, or a person who refuses treatment be judged equal to a person who has followed through on every level of treatment and has been given the (at least temporary) status by their mental health team of "stable"?

How about treating someone who has had little to no symptoms for over a year the same as someone who has extreme symptoms that interfere with their ability to function at a normal level without supervision or assistance?

What if it was a physical illness? Say a person diagnosed with the flu hasn't had any medication and has obvious symptoms wants to take care of your child, would or should their request be treated the same as someone who was diagnosed with the flu 2 weeks ago, got treatment and is symptom free wanting to do the same?

That's the basic problem I have with the stigma attached to mental health issues, but that's not the worst part of it.

What's worse is the implication that having a mental illness is something to be ashamed of, like it's your fault. That's what is so insidious and harmful about allowing people to label and dismiss or punish people who need help.

It makes some people hide. It makes some people not ask for help until things are dire. It makes some people stop taking their medications. It makes some people desperate. It causes unnecessary pain and suffering.

Are there people with certain issues that would indicate a need for caution when interacting with them? Of course! And not all of those people have a mental health diagnosis to give you a heads up. 

If you have to judge someone, use the information in front of you. Evaluate their behavior you have seen. If you don't know for sure what their personal symptoms are, try asking. With compassion and the goal of understanding, or even better, to help them.

Life in These United States - I feel less safe

My perspective

I am no stranger to stigma and bias. I have mental health issues. I have tattoos and piercings. I have lived below the poverty line during most of the phases of my life. I was a high school drop out. I had children out of wedlock, the first at a young age. I have close family members who deal with prejudice because of their race, and others because of sexual orientation- and by association, I do too.

It's not new. It's been a part of the fabric of this nation of diversity since the beginning. Repeatedly.

I have had experiences dealing with people who do not have my or those I care about's interests or needs in mind when voting or otherwise in control of making decisions that effect everyone. It's been difficult and I thought our nation was moving towards Inclusiveness and Tolerance.

But now is a scarier time. Words that would have been muttered behind my back, or out of earshot with like minded people are now shouted. Certain groups of people feel comfortable being disrespectful in public now. Some insulting people or refusing to serve them, some threatening or even attacking people.

These things were happening here and there before current events on a small scale. The difference is that these people have found champions. Role models. Certain leaders, politicians, or celebrities have shown in words and deeds that these behaviors are acceptable, or even ideals to strive for. There has been a shift.

In some ways I am lucky

I have privilege. I am white, middle aged, straight. I prefer what would be business casual type clothes. In certain ways these things protect me from being a target, but it also means some people feel free to comment negatively about groups I or people I care about belong to like I agree or accept their beliefs. And it is happening more frequently.

In some ways I am a target

My appearance choices have caused difficulty in the past, but if I cover my tattoos or wear a hat, I blend in. I prefer my hair extremely short and I like to dye it vibrant colors. I also have a squarish jawline and very broad shoulders for a woman. I don't wear make-up.

Last week I was mistaken as transgender and threatened. I was upset not only at being mislabeled, but for the treatment that no one should have to go through. 

What happened

At the store I went to use the restroom, and a man stepped in front of me and wouldn't let me pass. I was confused and said "Excuse me." He said "There's no excuse for YOUR kind." 

I was shocked and confused. I said, "What?" and tried to go around him. He blocked me again and put a hand on my upper chest/shoulder. "Where do you think you're going? My daughter's in there, you fucking freak. I suggest you just hold it till you get home unless you want me to bust up your face."

I turned and headed straight to customer service, shaken up and upset and scared. I started crying with the clerk there, and she got a manager. He didn't seem to believe it could happen here, or that anyone would think I was, in the manager's words, a "Man in Drag". I must have misunderstood the guy or something. But he offered to get an employee to escort me out to my vehicle. I accepted because I really didn't want to risk a run in alone in the parking lot with ANYONE. 

The most troubling thing happened on the way out. I thanked the employee walking me out to my car, and admitted I was scared by the whole experience. He replied that I might want to rethink my style then, or just get used to it. That looking the way I do was just asking for it.

"The way I do?"
"Yeah, well. The hair? Guy cut with the rainbow? Look like a freak, get treated like a freak."

Get used to it...

I guess it is acceptable to mistreat people based on assumptions you make about their appearance now? 

And the bigger alarm that went off was, people who actually ARE a part of this group should expect this as normal?

The message I got was that marginalized people now need to hide or know their place. The manager's message, whether intended or not, was that no one will believe them even if they do speak up.

The escorts words instructing me to change my appearance; to hide, or get used to it.

My thoughts

I am heart broken. I am angry. I am frustrated.

Not just for myself, but for every marginalized group out there right now facing these things. Every day there is another news article. Every day another person feels righteous enough in their fear and hate to lash out at another human being. 

This is such a big deal.

It is creating so much suffering. Not only for those who happen to have a certain label, but their loved ones and anyone unlucky enough to be caught up in it by chance due to a similarity in appearance.

I almost didn't post this.

I didn't feel I deserved a spotlight on my experience. I am NOT transgender. I was NOT physically harmed. I felt I had no right to speak.

And then this week 2 men who were from India were shot by a man that seemed to believe they were either middle eastern or immigrants. The details are still being gathered, but witnesses have confirmed the words he yelled. 

This is happening. Everywhere.

How many stories like mine are out there, unheard because only the most violent make the news?

How many are out there about people who do identify with one of the target groups who are silenced out of fear, or swept aside by people of privilege who agree with the hate?

If you or someone you love has faced anything like this, or fears you will...

I just want you to know you are not alone. And IT'S NOT OKAY. And I will stand by you, with you, or for you.

I WILL USE WHATEVER TINY VOICE I HAVE TO SHOUT AT ANY WHO WILL LISTEN.

Especially for those who don't have one at all.

Until I can't anymore.

speechless

I can't write about anything tonight. I am scared. I am hurt. I am lost. For myself, my friends, a good chunk of my family... I just... God help us all.

Following Through When You Can't

Like most people, I've made promises to do things. 

I fully intend to do exactly what I say I will.

And then something interferes with my plans, and I can't.
Maybe my priorities shift because of emergency situations.
Maybe my health fails me out of the blue.
Maybe a required part of the plan breaks or disappears.
Maybe the situation is much more complicated and my simple plan isn't workable.

I used to feel horrible when I couldn't keep a promise, because I have been on the other side of depending on others and having them not come through for me. Even if the person was understanding about it, I would beat myself up for them. It would mess with other parts of my life. My relationships could all suffer. My health sometimes suffered. And it fixed nothing.


Then I figured something out.
There are ways to keep the spirit of a promise, if not the letter of it. You just have to skip feeling bad and look at the possible failure as a challenge for creativity.

Here are some examples:

I promised to help a friend move, knowing she had no one else. The day of the move I was in a lot of pain and my van wouldn't start. I couldn't help her at all. So, I started calling in favors of other friends. I asked for help fulfilling this promise. I called my friend, apologized and told her my situation and what I was trying to do to still help her move. I asked her if there was anything else I could do for her. She was stressed and needed to talk so I sat on the phone with her for an hour. I managed to find a friend of a friend with a truck, and 3 volunteers to load and unload for her. So, I still ended up helping her move, even though I didn't.

I promised my kids when we moved to a small town that we would not move again before they graduated. I promised they would never have to switch schools again. A few years down the road, our house got foreclosed on. There were no rentals in that small town big enough for our family that we could afford. We had to move to a new school district. I set up with family friends and the school for them to stay there during the week so they could stay at that school. When that didn't work, I had several meetings and phone calls with the Principal and Superintendent and helped the now teenagers figure out transportation and then I filed the proper paperwork request for them to still attend out of district. They graduated from there.

But...

There have been times where I had to back out of social plans, and there is no way to fix that one.
When your promise is your attendance and you can't, there is no substitute.
That's when you have to figure out what the spirit of the promise is. For me and social activities, the promise is more about being supportive and involved in someone's life than actually just being in a certain place at a certain time.

So what I do is offer to spend time with them later, or offer that they can call me during or after the event if they want to talk. I request pictures and video of the event to show I care and comment on what I see in them. I follow up after the event and ask lots of questions about how it went, their favorite moment, or let them complain about what went wrong. Whatever lets them know I care about them and what they do.


And there have been promises that I had to break where all I could do was promise to do better next time. It happens. This existence is full of factors that are not within our control. Trying to take responsibility for those just drive you nuts. At those times you learn with the help of hindsight what precautions you can make for the chaos for next time. THAT is your responsibility. To learn. And thinking of it that way helps me not blame myself and cause extra damage when those things inevitably happen.

An overall idea in all of this is a truth I learned in DBT:

We are all doing the best we can, with the tools and information we have at the time. And we must continue to try to do better.

What's wrong with me?

I actually hate it when people ask me about my individual challenges in this life by asking what's "wrong" with me, but it's the fairly universal wording people use when they approach the subject.

In full disclosure, I have decided to list all the ways I have challenges that a lot of others don't. I will be pulling from this list for future posts to give insight, encourage others, and share what I have learned. Here we go.

My Mental Health Laundry List

current diagnoses:

Borderline Personality Disorder

PTSD

Generalized Anxiety Disorder

Social Anxiety Disorder

Panic Disorder

Dermatillomania

Major Depression

Body Dismorphia

Insomnia/Other Sleep Disorders

Various Phobias

past issues still causing problems:

Anorexia-Nervosa

History of Sexual Abuse

History of Emotional Abuse

History of Self Harm

Survivor of Bullying

Survivor of Date Rape

Survivor of Domestic Violence

Survivor of Suicide Attempts

previous diagnoses since changed:

Possible Mood Disorder (as a minor)

Bipolar II

Rapid Cycling Bipolar

Bipolar IV (not otherwise specified)

My Physical Health Laundry List 

(because it impacts the Mental Health)

current issues:

Fibromyalgia

IBS

Trans-Vaginal Mesh Implant Migration

Severe Allergies

past issues still having effects:

Permanent Damage from Injuries

Physical Changes/Side Effects After Surgeries

There are other minor things, but you get the idea. I have more than a few things I can talk about. I do consider myself in Recovery, but I still struggle. Yesterday was particularly difficult. 

If I can just help one person not feel alone or find one thing that helps them, I am a success.

When you don't know where to go for help

Partial List of Resources

I'm going to start with suicide prevention, education, and support because dealing with that issue is the most immediately life threatening and vastly devastating condition.

Most people know about the

National Suicide Prevention Hotline. 1-800-273-8255

But did you know they also have a text option?

You just text the word "Start" to 741-741

Also, they have on online chat option on their website, and links for specific populations like Youth, Disaster Survivors, Native Americans, Verterans, Loss Survivors, LQBTQ+Attempt Survivors, Deaf or Hard of Hearing, or (Ayuda En Español)Spanish Translation.

HERE: 

https://suicidepreventionlifeline.org/ 

Another online chat option with trained crisis staff can be found at:
http://hopeline.com/

And if you have lost someone, are concerned about someone, or an attempt survivor yourself:
you can also find links to specific support at The American Suicide Prevention Foundation.


Another thing I found is the project over at Live Through This. There you can read interviews with attempt survivors.
Their message to anyone considering suicide is "Please Stay".

Mental Health Information and Support

The National Institute of Mental Health has the latest information, research and links to finding help.

NAMI- The National Alliance on Mental Illness is all about education, support, and advocacy for the Mentally Ill. You can type in your state and find out what's available in your area.

The Mighty is a site with stories, articles, advice and information on a variety of diseases, disabilities, and mental illness.



In the future I will make posts dedicated to specific subjects I have personal experience with, so- stay tuned.

Story time- When I did everything right, and it still went wrong

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A little bit of background. I have been through decades of various therapies; learning what works and what doesn't and gathering tools to improve my quality of life.

I had a list of coping skills.
I had a list of social support people.
I had a safety plan.

I have used them all before, to varying levels of success. I was prepared and ready for whatever life dealt me...
or so I thought.

A couple weeks ago I pushed my limits to accomplish some things I thought were important, planning downtime to recover after. I came home to news that my disability was denied after I thought it was about to go through just in time to save me from becoming homeless. It triggered panic attacks, some PTSD issues, various anxiety disorders I have, and I started having some symptoms of depression.

So I noted all the red flags, and went through my coping skills. And I tried to do what needed done and make a new plan. My therapist was out of town, but I would see her next week. I just had to be careful.

The next day, my son contacted me. with happy but stressful and shocking news. The baby they were expecting is actually identical twins. Cue worry, fear, along with joy.

And then he let me know that an old friend lost his battle with depression and took his own life.

My world tilted.

It was just too much. Within a few hours I knew I was in big trouble. I pulled out my safety plan.

I called the first person on my list to find the number no longer in service. I later realized I hadn't updated it when she got her new phone. I called the second person- straight to voice mail. Waited an hour, again straight to voice mail. I found out later she hadn't been able to pay her phone bill and it had been turned off the day before. I called the third, and due to her current circumstances, she ended up saying the wrong things and invalidating me and then dumped her own problems on me. I cried.

Trying to get a grip on myself, I went through the rest of my safety plan. What I found was that I hadn't updated it in a while. A lot of my go-to soothers were having to do with my companion pet, Missybaby, who passed away this past spring. Just reading them brought a fresh wash of grief over her.

Another section was all about doing art, but my old friend was an artist. It triggered me instead of helping.

Crafts? No supplies and no money to buy any.

Listen to music? I no longer had a way to play my CDs, and my ex has my mp3 player. I tried listening to the radio, but too many sad songs.

And that was it. No more prepared options.

So what did I do?

I kept the suicide hotline number at the ready, and I got online. I sent out a call for help on twitter to a group of strangers who all deal with mental health issues, and have been known to be there for anyone waving a surrender flag. And there were answers. I was not alone. I searched and found more online support. I found personal stories proving it gets better. I forced myself to open up at my weekly NAMI meeting and got some support. I searched and found uncommon coping skills lists, and found a few more to try. I got a free month of Amazon Prime and got music and movies and tv shows to encourage and uplift my mood. 

I let things go that weren't essential. I was gentle with myself, only doing what I needed to do without judging my choices. I worked on a plan of action over the things I could control. And I made it to my next appointment where we started revamping my safety plan.

I was lucky.

In the past, it hasn't worked out that well for me. There have been many times my safety plan just wasn't good enough to keep me out of the hospital. There have been times I waited too long to try, and later was told there is no logical reason why I survived. I don't think those times were worse than this one. It could have easily gone that way again.

The difference was perhaps experience. Or that I didn't give up. Or that I stumbled on impromptu support. Or a combination of those.

I learned that I need to make a backup plan for when my go-to stuff doesn't work. I learned how to carefully seek support without increasing my vulnerability or grasping toxic people out of desperation.

And I am still here.