I’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.
- Roadblock: When Mental Health Stigma Prevents Treatment of Physical Pain
- 5 Reasons People Abandon a Sick Friend
–Your Stylist, Jessica Gimeno
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