Robin Williams died Monday. It seems that everyone is talking about how his death touched him or her, and lots are saying how his death might finally help eradicate the “stigma of mental illness.” For me, it was surreal to get the news of his death, as my daughters and I had gathered ’round to re-watch “Dead Poets Society” just the night before he died. We fell in love all over again, with his voice, good looks, and the beautifully-delivered lines which were still fresh in our memories when we heard the tragic news that he’d killed himself. I felt profoundly sad for his wife and kids. How horrible they must feel, I thought. This reminded me that I used to think that suicide was nothing more than a selfish act, meant to inflict great pain upon those surviving the victim. Now, I’m extremely embarrassed and ashamed that I would harbor such thoughts. That mind-set is part of the “stigma of mental illness” to which the talking heads refer; it’s ignorant, sanctimonious, and intolerant. It’s taken some of us an awfully long time to realize that depression, and many other disorders, are forms of mental illness.
My daughter has devoted the last eight years to the pursuit of a career in Psychology. She is now in the midst of a Ph.D. program in Clinical Psychology. She’s at home at the moment, so I thought I’d pick her brain about this issue. While she’s not an expert (yet), she certainly has more experience than the average bear, so, here we go.
Claire, since Robin Williams’ death, people are talking about the “stigma of mental illness.” What does that mean to you?
CK: I believe there is a lot of stigma associated with mental illnesses in general; people are reluctant to let others know they’re suffering because they’re afraid of what people will think of them. They hear people with mental illness called derogatory names, like “crazy” and “lunatic.” The media often portrays people with mental illness as dangerous. Education is lacking; people are afraid they’ll lose their jobs if they admit they have a mental illness, because their boss may think it makes them unsuitable to do their job. I think another reason it’s stigmatized is because we often feel that the patient is at fault and somehow responsible for their suffering. Even people with mental illness sometimes feel that they’re weak because they realize that they can’t help themselves.
Aren’t the prejudices different depending on the illness?
CK: Yes, but I think all mental health disorders are stigmatized, some more than others, especially those that involve psychosis, like schizophrenia, because people with that diagnosis often make us feel uncomfortable. It can be more severe and chronic.
So why do you think most people can’t think of mental illness like a disease such as cancer or diabetes?
CK: Lay people often don’t understand what mental illness is and have the misconception that it’s the patient’s fault and that they’re struggling because they’re not trying hard enough. And, without medical tests to determine what the problem is, diagnosis is difficult and even experienced professionals can disagree about the diagnosis. They’re often not the clear-cut picture that’s laid out in the DSM; there are usually a number of symptoms and over-laps between diagnoses. And, medications aren’t necessarily a quick fix. It may take awhile to find the appropriate drugs, therapy, or combination of the two to appropriately treat the patient. And, a lot of these diagnoses are chronic, life-long, and therefore, must be constantly monitored, and treated for flare-ups.
People seem hopeful that Williams’ death will help to eradicate the stigma surrounding mental health. Do you agree?
CK: I don’t think that it will eradicate the stigma, but I hope that it helps decrease stigma, and it may. He was so well-loved by so many, people suffering from depression may think that if Robin Williams was so depressed, then they can say that they are, too. People may find acceptance in that.
My friends and I have commented that it seems that certain illnesses are diagnosed more frequently today than they were when we were young. Like, ADHD, depression, etc. Do you think that means we’re getting better at seeking help and recognizing those who need help? The implication seems to be that there is over-diagnosing and over-prescribing of drugs.
CK: We are better at diagnosing certain disorders because they’re better defined and more recognizable. People are a little more willing to seek help, and there are a few more treatments available. ADHD is a special case, though. Parents and teachers often want a quick fix for disruptive classroom behavior and learning difficulties, but I’ve researched how it is under-diagnosed in girls, especially minority females, because of differences in symptom expression. Girls tend to be inattentive and suffer quietly whereas boys often act out, and are disruptive in the classroom.
What particular experience have you had in observing how mental illness stigma has affected people?
CK: When I worked at an eating disorder clinic, I saw girls who were in treatment for a week or so, and their families would ask if they were feeling better and ready to leave treatment. They wanted them to get well so badly, but they didn’t understand that it takes a long time, it’s a process. I also saw girls who were very reluctant to tell anyone about their disorder. Clients felt really guilty when they heard about the suffering of others, like hunger in Africa, etc. Even they didn’t realize they had an illness and couldn’t help it.
What advice would you have for parents who suspect their son or daughter is suffering from depression or any other mental health problem?
CK: The most important thing is to seek help early and realize that you, as the parent, may not be able to help them. Don’t be afraid of taking your child to a mental health professional, just because you may not have heard of anyone else doing so. Keep the lines of communication open; make sure you let your child know you love them, you’re not judging them and that it is not their fault that they aren’t feeling well. Be patient with them; they may not want to engage in the activities that they’d normally be interested in. They may be irritable and cause conflict in the home. Try to understand and meet with their psychotherapist or psychiatrist if the child is under 18 in order to get advice on how to best help them.
Do you think that you and others working in the mental health sector can reduce stigma?
CK: Yes. I hope to raise mental health awareness in my community by speaking to schools, parents, kids, and physicians about types of and signs of mental illnesses, and how to seek help. One of my goals is to help reduce mental health stigma, which could possibly reduce the number of suicides due to people’s fear of seeking help, and to help treat children suffering from various psychological disorders.
And, hopefully, we lay people will help you in that endeavor by trying to be more empathetic and understanding of others; we truly don’t know what they‘re going through, even if they appear to have it all.