Stigmatization of People with Mental Disorders


"Stigmatization of people with mental disorders is manifested by bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance. Stigma leads the (public) to avoid people with mental disorders. It reduces access to resources and leads to low self-esteem, isolation, and hopelessness. It deters
the public from seeking, and wanting to pay for care. Stigma results in outright discrimination and abuse. More tragically, it deprives people of their dignity and interferes with their full participation in society."

--U.S. Surgeon General Dr. David Satcher (ret.)

Wednesday, May 5, 2021

Misconceptions About Bipolar Disorder

 

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Please Stop Believing These 8 Harmful Bipolar Disorder Myths

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What do successful people like musician Demi Lovato, comedian Russell Brand, news anchor Jane Pauley, and actress Catherine Zeta-Jones have in common? They, like millions of others, are living with bipolar disorder. Although we are learning more about bipolar disorder, there remain many misconceptions. Here are a few myths and facts, so you can arm yourself with knowledge and help end the stigma.

1. Myth: Bipolar disorder is a rare condition.

Fact: Bipolar disorder affects 2 million adults in the United States alone. One in five Americans has a mental health condition.

 

2. Myth: Bipolar disorder is just mood swings, which everybody has.

Fact: The highs and lows of bipolar disorder are very different from common mood swings. People with bipolar disorder experience extreme changes in energy, activity, and sleep that are not typical for them.

The psychiatry research manager at one U.S. university, who wishes to stay anonymous, writes, “Just because you wake up happy, get grumpy in the middle of the day, and then end up happy again, it doesn’t mean you have bipolar disorder — no matter how often it happens to you! Even a diagnosis of rapid-cycling bipolar disorder requires several days in a row of (hypo)manic symptoms, not just several hours. Clinicians look for groups of symptoms more than just emotions.”

3. Myth: There is only one type of bipolar disorder.

Fact: There are four basic types of bipolar disorder, and the experience is different per individual.

  • Bipolar I is diagnosed when a person has one or more depressive episodes and one or more manic episodes, sometimes with psychotic features such as hallucinations or delusions.
  • Bipolar II has depressive episodes as its major feature and at least one
    hypomanic episode. Hypomania is a less severe type of mania. A person with
    bipolar II disorder may experience either mood-congruent or
    mood-incongruent psychotic symptoms.
  • Cyclothymic disorder (cyclothymia) is defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least two years (1 year in children and adolescents) without meeting the severity requirements for a hypomanic episode and a depressive episode.
  • Bipolar disorder otherwise not specified does not follow a particular pattern and is defined by bipolar disorder symptoms that do not match the three categories listed above.

4. Myth: Bipolar disorder can be cured through diet and exercise.

Fact: Bipolar disorder is a lifelong illness and there currently is no cure. However, it can be well-managed with medication and talk therapy, by avoiding stress, and maintaining regular patterns of sleeping, eating, and exercise.

5. Myth: Mania is productive. You’re in a good mood and fun to be around.

Fact: In some instances, a manic person may feel good at first, but without treatment things can become detrimental and even terrifying. They may go on a big shopping spree, spending beyond their means. Some people become overly anxious or highly irritable, getting upset over small things and snapping at loved ones. A manic person may lose control of their thoughts and actions and even lose touch with reality.

6. Myth: Artists with bipolar disorder will lose their creativity if they get treatment.

Fact: Treatment often allows you to think more clearly, which will likely improve your work. Pulitzer Prize-nominated author Marya Hornbacher discovered this firsthand.

“I was very persuaded I would never write again when I was diagnosed with bipolar disorder. But before, I wrote one book; and now I’m on my seventh.”

She has found that her work is even better with treatment.

“When I was working on my second book, I was not yet treated for bipolar disorder, and I wrote about 3,000 pages of the worst book that you have ever seen in your life. And then, in the middle of writing that book, which I just somehow couldn’t finish because I kept writing and writing and writing, I got diagnosed and I got treated. And the book itself, the book that was ultimately published, I wrote in 10 months or so. Once I got treated for my bipolar disorder, I was able to channel the creativity effectively and focus. Nowadays I deal with some symptoms, but by and large I just go about my day,” she said. “Once you get a handle on it, it’s certainly livable. It’s treatable. You can work with it. It doesn’t have to define your life.” She discusses her experience in her book “Madness: A Bipolar Life,” and she is currently working on a follow-up book about her road to recovery.

7. Myth: People with bipolar disorder are always either manic or depressed.

Fact: People with bipolar disorder can experience long periods of even, balanced mood called euthymia. Conversely, they may sometimes experience what’s referred to as a “mixed episode,” which has features of both mania and depression at the same time.

8. Myth: All medications for bipolar disorder are the same.

Fact: It might take some trial and error to find the medication that works for you. “There are several mood stabilizers/antipsychotic medications available to treat bipolar disorder. Something that works for one person might not work for another. If someone tries one and it doesn’t work or has side effects, it’s very important that they communicate this to their provider. The provider should be there to work as a team with the patient to find the right fit,” writes the psychiatry research manager.

Takeaway

One in five people is diagnosed with a mental illness, including bipolar disorder. I, like so many others, have responded extremely well to treatment. My daily life is normal, and my relationships are stronger than ever. I haven’t had an episode for several years. My career is strong, and my marriage to an extremely supportive husband is a solid as a rock.

I urge you to learn about the common signs and symptoms of bipolar disorder, and talk to your doctor if you meet any of the criteria for diagnosis. If you or someone you know is in crisis, get help immediately. Call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (8255). It’s time to end the stigma that prevents people from getting the help that can improve or save their lives.

 

Tuesday, March 2, 2021

Tempered Soul ~Surviving Childhood Trauma, Grief, and Bipolar Disorder

 Tempered Soul

Surviving Childhood Trauma, Grief, and Bipolar Disorder  

Prologue~May 2023.

I grew up when mental illness was a social stigma. My memory emanates from a lifelong battle with my demons. It was a time when there was no applause, no public accolades for undergoing treatment. It was commitment, plain and simple. Mental illness or dependencies were defects of character and cause for social isolation and job discrimination. People did not talk about it, and if it touched their lives, it remained hidden away with shame. There were no chic or trendy clinics, just dark institutional wards tucked away in the recesses of hospitals.

I was 20 years old when I was ushered through those padlocked gates to find myself surrounded by madness. There was no Nurse Ratched, but the levels of mental illness I encountered covered the spectrum: psychosis and schizophrenia; lost souls haunted by delusions, and dementia. Many like me were buried under despair so deep we had pursued a death of our own design. Walking those halls of silence and screams, you learned quickly to avert your head for fear of recognizing your pain in the eyes of another. I still see those eyes as I watch the nameless and homeless who wander the streets of anonymous cities, trapped in a world where they are no longer sons or daughters, mothers or fathers, sisters or brothers.

I was luckier. I was young, and the doctors felt confident that my therapy had exorcized my madness. After six weeks, I returned to the world of the sane, hiding my illness, learning to overcompensate exponentially, determined to outrun that two-headed beast who would remain unidentified by every doctor I saw over the next 29 years. I took the reins and embarked on a successful career that would span more than two decades.

During those years, I saw the Americans with Disabilities Act and the Family Medical Leave Act pass. Companies expanded benefits coverage to include a mental health component. Depression made its way into conversations in the break room and over a glass of wine. Management allowed time off for visits to mental health professionals. The pharmaceutical industry thrived, finding a lucrative demand for drugs that promised to ease depression and anxiety. Suddenly everyone was either on Prozac or knew someone who was, and even though people were talking about it, the stigma remained like a whisper hanging in the air.

So, I did my best to conceal my emotional disfigurement from the world around me. It was the only life I’d ever known, so I let myself believe I was quite normal, just like everyone else. I quit looking over my shoulder and drove myself harder. When I wasn’t paying attention, it caught up with me. I began to lose my ability to hide the demons I had suppressed for so many years. I found myself unable to function on a sustained basis and burned through sick leave like a spark on gasoline. Vicious rages contorted me like a willow in a Nor’easter. The tide surged in, and I watched the foundation of my life crumble in its wake.

At the age of 49, I learned that, like more than 8 million Americans, I suffer from bipolar disorder. For almost four decades of my life, this condition remained unnamed. I heard so many misdiagnoses: hyperactivity, alcoholism, panic disorder, ADHD, post-traumatic shock, and clinical depression. One doctor said I had aged into the extremes of my illness. Another said I had overcompensated for so long, I had nothing left.

Bipolar disorder, often referred to as manic-depressive illness, dissipates a person's ability to live a normal life. An addictive intensity and creative drive often accompany the initial phases of this illness, but the cycles of paralyzing depression and intrusive mania can drive an individual to self-destruction. The price of this illness is high. Close to fifty percent with the disorder attempt suicide at least once; of those, one in eight fails to survive; paradoxically, they succeed in their efforts to end life.

The injury to my own life has been immense. It cost me my career and many relationships along the way. On several occasions, it nearly cost me my life. The white scars tattooed on my arms and wrists remind me of the much deeper scarring of my spirit.

Five doctors confirmed my diagnosis (rapid-cycling bipolar 1), and at the time, it felt like a death sentence. Seven years passed as I became the subject of unsuccessful pharmaceutical experimentation that strove to tame my illness's rapid cycles. Some of the drugs made me sick. Some exacerbated my polar extremes. Two damn near killed me.

After so many failures, I told one of my doctors, this is not living. That was when I finally agreed to undergo electro-convulsive therapy (ECT), something that had always terrified me. After fourteen sessions, they stopped, deciding that immediate relief did not outweigh the damage to my cognitive function. ECT had left me with short-term memory loss, unable to focus and do things that brought me joy—reading, writing, listening to music, and participating in social activities. I developed severe agoraphobia and could not even walk to my mailbox. I became isolated from the world.

As I struggled to recover balance in my life, I learned despite legislation and health benefits, stigma and discrimination are ever prevalent. Many people chose to step away when I approach, awkward and unsure who I would be at that moment. I have encountered a staggering amount of ignorance and a complete lack of empathy from many people I considered friends. Just snap out of it, they would say to me. I wanted to scream: Do you think I want to be like this? I have forgiven those who dropped by the wayside during those years; Unmanaged bipolar disorder in its extremes is ugly.

The media continues to defame this disorder, using labels such as crazy, insane, and psychotic. I only have to surf the channels to see another derogatory stereotype of this illness played out for me. The worst commentary I heard defined bipolar disorder as the new fashionable diagnosis. Fashionable? Whoever said that should spend a few weeks in my skin. There is nothing fashionable about losing your career, your friends, or your life. I hide in my house, incapable of doing anything that requires focus. I go days without eating or sleeping, caught in a shutter-speed blur of thoughts. When the euphoria subsides, the agitation and rage set in. I do not know this person; Still, the manic monster pushes me to go faster, assuring me of a magnificent possibility. I am seduced beyond reason. I never see my wings melting in the sun. I know all too well the hell that will follow. I can only find peace in sleep, and my bed becomes a refuge and, paradoxically, a prison for days.

Despite it all, I am still here. I finally learned this disorder does not define me. I have a disorder that takes monumental vigilance and strict adherence to a daily regimen of medications. Every setback teaches me something--behaviors, triggers, responses–learning to reach out when I know I need support.

I no longer fear the social stigma and the silent prejudice many people still harbor about mental illness. It requires stamina and understanding to love me despite my erratic and irrational behavior; to seek me out when I disappear into that state of despair-induced paralysis; to listen when I speed through a digressive one-way discourse; to painfully watch my self-destructive rages. Today, I am more level, more grounded, and more able to control the demons determined to rip my life into two equally painful states of being.

“Bestowed” with this genetic disorder at birth, I am still grateful for the expanse of the feelings I have experienced. Ironically, the meter of my emotions has been carved into my soul, tempering it with sparks of brilliance. I am blessed by those who unconditionally love and celebrate me. Without this support, I have no doubt I would be dead. Today, I have learned there is joy in the middle ground.

With the fervent hope I might help another, I tell my story.

 

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