May is Mental Health Month, designed to create and increase awareness about mental health. We cringe at the mention of “Mental Health” and yet we all sometimes think about it at some level. It is common knowledge now that there is a strong mind-body connection. If we are physically ill with a fever, then we feel either unmotivated, irritated, or “down”. If we are not feeling well mentally then we lack physical energy and can incur physical symptoms such as headaches or stomach aches. We can get psychosomatic symptoms due to stress, anxiety, and grief. For a fever, we take Tylenol and if that doesn’t work, then we call the doctor. However, as easily as we go to the doctor if the fever escalates, we do not do the same if we feel ill mentally even in the face of consistent depressive symptoms like feeling on edge or excessive worrying.
What is stigma?
There are multiple reasons for our resistance to seek professional help for our mental health needs. The biggest reason is the stigma associated with seeking help for mental health. The National Alliance on Mental Illness (NAMI) defines stigma as “when someone, or even you yourself, views a person in a negative way just because they have a mental health condition. Some people describe stigma as a feeling of shame or judgement from someone else. Stigma can even come from an internal place, confusing feeling bad with being bad.”
This means that there are two types of stigmas; public stigma and self-stigma. If you visit a physician for physical illness you can take sick leave, your colleagues will wish you well, you can eat chicken soup, and complain about being sick. If you take a mental health day then it’s a different story. First of all, you can’t really say that you need a “mental health day” because it is not accepted in our society. You fear that people will start talking about you as “going crazy”, “so overwhelmed”, or gossip by saying you “can’t keep it together anymore”. This is public stigma. It’s fear of rejection and discrimination, in addition to shame and guilt. You fear diminishing your worth in the eyes of the society.
Self-stigma comes in when we devalue ourselves for having mental health issues. Our self-esteem and self-image takes a hit. We think we are less capable than the next person. We also blame ourselves for not being able to handle it. We can feel shame for feeling the way we are feeling. Self-stigma keeps us from seeking help and getting better. We feel like we are living 2 different lives. We put on a face in public, try to act as normal as possible, go to work, try to take care of responsibilities at home, try to attend social gatherings. Our other self is secret. Only we know how we are feeling inside. We don’t want to attend the party but go anyways because of the fear of inquiries. Getting up in the morning becomes a chore, small talk with colleagues a nuisance. We get irritated if kids are playing loudly or if our wife reminds us of getting milk. Yet, we hide our true feelings, our honest thoughts and our sickness. Those denied feelings start leaking in different ways: having a short fuse, avoiding people, lack of sleep, or overeating. Then one day, we explode.
According to NAMI, 1 in 5 Americans live with some sort of mental illness. The average delay between the onset of symptoms and intervention is 8-10 years. This is largely due to stigma associated with getting mental health help from professionals. There is also a cultural side to this issue. In some cultures even talking about mental health is taboo. There is a misconception that “we don’t have these kinds of issues; it’s a Western world problem.” When I decided to be a therapist, a common reaction from my Indian relatives and friends back home was, “Oh yeah. Americans have a lot of mental health issues.” When I pointed out some of the situations in India, they were brushed off as minor issues. In collectivistic cultures, family and personal issues are not discussed with outside professionals for the fear of shame, disrespect, or humiliation it can bring to the person and the family. Very close friends and relatives become the first and only source of help. There is a lack of acceptance of mental health issues, so getting help for them is challenging.
What happens when we don’t get help to keep fit mentally? Who suffers? The answer might surprise you. It is not only the person who is suffering with mental health issues, but also all the people around that person who suffer one way or another. That includes immediate family, friends, and colleagues. Research has shown that children growing up in households with mental health issues, domestic violence, alcoholic parents or abuse are at a greater risk of mental and physical health problems as children and that continues into adulthood. The society at large faces the consequences of mentally unstable individuals in the form of homicides, accidents, assaults on people and property.
Misconceptions about therapy
There are also a few misconceptions about therapy which can become a barrier in seeking help. Let me try to clear some of the misconceptions-
1. Only crazy people need therapy
Therapy is for everyone who is not functioning well due to mental health issues and it is temporary. Maybe their depression is associated with the death of a family member resulting in lack of energy, anger towards people around them, and feeling hopeless or worthless. They feel like they are just going through the motions of life. Therapy can help them process the grief, relieve the burden, and also can provide tools to deal with it. It will result in reducing the time to get back to a functional state.
2. Therapists make you talk about uncomfortable personal things. Therapists ask about all your life and secrets
Therapists do not make you talk unless you want to. I myself have sat in silence with my clients multiple times because sometimes silence is what is needed. There are various approaches to mental health including mindfulness, yoga, art, and music. There is an increasing trend towards holistic approaches to heal your mind and body.
3. The therapist won’t understand what I went through so how would they help? Why should I tell my life story to a stranger?
It is true that you, not your therapist, have lived your life so you are the expert on that. A good therapist would never claim to know it all. You can help your therapist understand your worldview and perceptions, and your therapist can recommend a few things that would help you get to your goal.
4. Once you go to therapy you have to go all your life
The duration of therapy depends on your symptoms, your goals and your willingness to participate. There are various therapeutic modalities including brief therapy. You collaborate with your therapist to decide which one is best suited for your needs. Therapy is voluntary in most cases. You can stop it anytime you want. However, premature discharge can complicate or worsen mental health.
5. Everyone would know that I am going to therapy.
Your therapy sessions are confidential. That means your therapist cannot release any of the information without your permission to any person including your spouse, your doctor, or your lawyer. A few exceptions are court mandates and mandated reporting of child and elder abuse.
What you can do to help end the stigma
Help start the conversation
Be open about supporting mental health. Speak up, declare your support for people who are trying their best in spite of their mental health challenges. Post positive quotes about mental health on social media.
Be open to learning about mental health
Ask questions of professionals, do your own research from respectable sources on the internet, increase awareness about mental health issues to clear misconceptions.
People suffering from mental health issues need their support system the most. It might not be easy to approach them because they might get irritated easily or might not seem friendly. If you see your colleague, friend, or relative suffering, try to lend a hand of help. Just let them know that you are there for them if they need to talk. Do not shun them because they are behaving differently. Discuss alternatives including going to a professional. Support them in seeking help. It helps to differentiate them from their condition.
Social media blues
Studies have shown that social media can contribute to mental illness. Be aware of how it is affecting you. Be mindful of your responses, and your time spent on social media sites, whether it’s Facebook, Twitter, Instagram , Snapchat, or any other app. Be mindful if your self-image, self-worth, and happiness is becoming dependent on likes and smiley faces you get on your posts. Are you getting competitive? Similarly, notice a shift in your friend’s responses. If they are getting snappy, short, or overly sarcastic approach them to see if they need help.
Be mindful about your mental fitness. Just as we exercise to keep physically fit, exercise your mind to keep mentally fit. Pick a hobby, practice mindfulness, eat healthy, and exercise - regular exercise helps the body and mind stay healthy by balancing chemicals. Be kind, help others, read a book, listen to music, or plant a garden. All of these things help you relax and be productive which boosts your mood and provides positive energy.
Get professional help
If your mental health issues are affecting your functioning, your sleep, or your relationships then get professional help. It is a first step in the healing process. Do not let the stigma stop you from getting better and being “yourself” again. The earlier you get help, the quicker and better the results.
Take care of yourself! There is only one of you in this world!
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