Why I Stopped Saying “Mental Health Stigma;” Calling a Spade a Spade

fotolia_21366483I’ve recently come to hate the phrase “mental health stigma” despite years of working in mental health nonprofit. To illustrate my point, I turn to Mad Men.  As Fashionably ill readers know, I’m a fan. Did you see the half-season finale? Note Pete’s sexism. At their latest staff meeting, Pete undercuts Peggy. Again. After she explains the game plan for their presentation to Burger Chef, he asks harshly, “Is that what you’re going to say?” Never mind the fact that Peggy knows this account better than anyone—she’s been to 26 different Burger Chefs in nine states! After Peggy, it’s Don’s turn to rehearse his part. Three seconds into Don’s part, Pete says, “That’s fine.” Peggy looks frustrated. In the previous episode, Pete reassigns the lead to Don after “complimenting” Peggy by saying, “She’s as good as any woman in this business.” He never comes out and says Peggy is less competent or intelligent than the men but any viewer can tell Pete is sexist.

What “Stigma” Hides

When someone has a sexist or racist experience (like Peggy had), it’s okay to call the guilty party sexist or racist. But somehow when people with mental illnesses are treated with the same derision, it’s different. It’s not discrimination. It’s not bigotry. It’s “mental health stigma.” Stigma masks the ugliness of bigotry and the pain caused by discrimination. While we may use it with the intention of educating others (I’ve used it too), what we’re really doing is minimizing the prejudice and disrespect inflicted upon people with mental illness. Bigotry can happen at school, at work, at home, and yes, even in healthcare.

A Humiliating Moment

I have several doctors in my family—two of them were even Chief Resident. I remember an experience I had in 2008 just weeks after Myasthenia Gravis (my autoimmune disease) had almost killed me. After undergoing treatment (plasmapheresis), I went to a prestigious clinic to be treated for MG. I stayed there for two weeks. The first day the neurologist assigned to me treated me well. He listened to me as I talked about the excruciating pain. When I told him about the pain in my hands and feet, he said he would “get to the bottom of it.” I was relieved. (Cramping and fasciculation in the hands and feet is common to patients who are on a combination of Prednisone and high doses of Pyridostigmine.) But the next visit, after another doctor stressed the fact that I have bipolar disorder, my neurologist treated me differently. I told him that I needed a solution for my pain—it was too much to bear. For months, I screamed through the night unable to sleep. He told me dismissively, “You’re just depressed.” I said I was not depressed because, well, I wasn’t depressed. (I was 24, and had been managing my bipolar disorder well for years.) Then I told him that I’d been reading this book at the clinic’s library about cramping caused by the meds and he snapped at me! He actually closed the book shut and yelled, “You’re just depressed!” Finally, I said firmly, “I’m not depressed. Just because I have bipolar disorder, does not make me a liar.” I’ll never know how I had enough composure to say that without crying. It was the most humiliating experience of my life.

(That man is not my neurologist. I’ve been seeing a wonderful neurologist for the past five years.)

Let’s Call a Spade a Spade

In recounting this story to doctors in my family, I was dismissed. I heard things like, “No he didn’t yell at you.” I wanted to respond, were you in the room that day? I also heard things like, “You must have gotten it wrong.” Anything to not call this what it was—bigotry.   Some relatives who are not doctors also reacted the same way. Had this been a racist or sexist experience, my relatives would have called it bigotry. Let’s call a spade a spade. Mental health discrimination is discrimination. Being treated less than human is not “stigma.” Stigma is a fancy word we use so we don’t offend people. It’s also a word that makes it easier for bigotry to flourish.

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Hi there! I am a patient advocate, writer, and public speaker most well known for my TEDx Talk, “How to Get Stuff Done When You Are Depressed.” As someone who is juggling 5 illnesses: bipolar 2, myasthenia gravis, endometriosis, psoriasis, and asthma, I’m passionate about helping people who navigate life with both chronic physical & emotional pain. If you’re interested in hiring me to speak at your event, check out the CONTACT tab.

5 thoughts on “Why I Stopped Saying “Mental Health Stigma;” Calling a Spade a Spade

  • May 28, 2014 at 7:10 am

    Wow! I never thought of it that way, but you are SOOO right! We say stigma so as not to offend, but what we’re doing is making excuses for the ones who are really being offensive. This puts the burden back on the patient. When you show the parallel to racism or sexism, it’s so clear! The only way things can change is by calling out that they are unacceptable add they are. Way to go for responding to that doctor as you did, and bravo for changing docs after that. Let’s hope more people can follow your lead!

  • June 8, 2014 at 9:23 pm

    I have come across this in healthcare myself. It makes me angry to no end. I have been battling ongoing symptoms, and once they find out my mental health history, any shred of respect they showed me dissipates. It needs to change. I am so sorry you have to battle MG such a terrible disease.

  • October 9, 2014 at 6:48 pm

    Yes mental health stigma is always going to be around, mad men nutters crazy -language of bigotry..still racism sexism will always be around too. Cant change people by arguing ONLY By doing. Film making songs, art writing you know.My spiritual teacher told me ” We are all mentally ill if we attached to this creation.” so thats 8 Billion mentally ill people ..not a problem right? Do pay any mind to people, you a confident mentally ill person just like any other mentally person in the world. Love those who shit on you…put up that umbrella, collect that shit in a bag, and leave it in there car,……….

  • January 15, 2015 at 2:32 pm

    As a mental health advocate and patient (who has personally fought endless stigma & discrimination) myself, I don’t quite agree with this black-or-white fallacy. “Stigma” is not a docile version of “bigotry” or “discrimination.” In fact, none of these 3 words are interchangeable with each other; each word carries a careful, differently nuanced connotation, and each and every one of them is necessary in illustrating the full, multi-faceted negative experience. “Stigma” is defined as “a mark of disgrace associated with a particular circumstance, quality, or person” which definitely remains a profound problem for the mental health community – this word carries significant weight & needs to stay in our conversation. I don’t believe this ” false dilemma” logic that one can trivialize or deduce a word and a whole experience, just by using another tangent word.

    • January 29, 2015 at 9:50 pm

      Hello Celia,
      Thank you for taking the time to share your opinion and experience. I think mental health discourse is richer for having multiple perspectives, which is why I often share blogs written by advocates I do not 100% agree with on Twitter or Facebook.

      First, I wrote this as entry as a woman of color who has also experienced racism and sexism. The mental health community has a tendency to use esoteric terms that are more passive in comparison to words used by other movements, which have achieved more than we have. In the Civil Rights movement and women’s rights, they used the words “discrimination” and “bigotry”—not stigma, bias, or ignorance. For instance, women made 58 cents to a man’s dollar. While we have work to do, women now make 75 cents to a man’s dollar. I don’t think using words like “bias” or “ignorance” work in trying to achieve mental health parity and getting people with mental illnesses to be treated with basic human dignity. Intentional or not, it’s discrimination. I do not believe that advocates for civil rights or women’s rights would have achieved as much had they used more academic and/or passive words. I have had a hard time rallying people to the cause of mental health advocacy using many of the words our community has used such as “mental health stigma” or “consumer patient led.” People, especially those with no experience with mental illness, often ask me what “stigma” is. By contrast, “discrimination” is accessible, effective, and engenders empathy.

      Second, in my experience, all discrimination has felt the same—whether it was being treated less than for the color of my skin or for having a bipolar diagnosis. While some racism is intentional and some unintentional (ex: people with foreign names on resumes not getting called back), it’s all discrimination.

      Thank you for sharing a different perspective.


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