...what creates stigma...

 From our team:

Stigma.

Small word. Big impact. 

Defined as “a mark of disgrace associated with a particular circumstance, quality, or person”, stigma has been applied to mental/emotional health with such frequency and carelessness, that we are all at risk of undue suffering…whether by individual lack of treatment and accommodation for self, or reactive difficulties brought on by the struggles of those we care about in our lives.

Clearly, the stigma relating to mental/emotional health is a problem for all.

But why, in 2022, are we still stigmatizing mental/emotional health, both the diagnoses and the care?

Easy answer?

It’s insidious.

~~~

First off, and perhaps most problematic, is the false correlation of mental illness and mental health that’s grown to be so prevalent in social discourse today. Mental Illness is a blanket term, albeit outdated, in reference to psychological conditions that are typically a deficit with little to no resolution. It used to cover a lot more in relation to diagnoses, but it carries a deeper weight and connotation, very often with a persistent degree of dehumanization. Mental Health is in reference to one’s psychological and emotional state, often correlating with short-term diagnoses such as depression, anxiety, and preemptive posttraumatic symptoms.

A lack of care towards the former generally leads to the latter suffering, but it’s not the sole cause. Regardless, many tend to steer away from the term because of the context of previous “psychiatric treatment” and the inflammatory connotation in today’s social environment.

Contributing to that false correlation is something perhaps a little more annoying at an individual level…medical practitioners aren’t always on the same page, so to speak. The DSM, or Diagnostic & Statistical Manual of Mental Disorders, is a broad, heavily referenced resource. However, previous versions of the DSM were reductive at best, essentially making “large sweeping hand gestures,” as understanding within consensus remained poor. 

The unfortunate part?

People still frequently refer to DSM IV, and DSM V, whereas the current, and most thorough version thus far, is the DSM V-TR. In other words, it’s the equivalent of a neuroscientist referencing phrenology. As such, preemptive associations were reached that, when mixed with poor phrasing, led to correlations that filtered down to the practice itself. Likewise, previous generations would teach things to the next generations the way they understood those concepts, resulting in a degree of persistence as well.

Perhaps the most disturbing factor in all of this, though, would also be an element of the stigma itself. Ignorance, Hate, Greed…the purest of motivations, not on account of whatever aspects, but simply on account of how frustratingly predictable they are. As is often the case, people hate adapting, and that extends to knowledge. At some point in time, many of us got it in our heads that science is prescriptive rather than descriptive, and turned away from the idea of revisions, of corrections, of expanded knowledge, and invariably, others suffer because of it. Terminology gets used as a descriptor when it shouldn’t be, all because of this. In turn, perhaps due to ignorance, or perhaps due to utter hatred towards those who are different, those in positions of authority maintain a steady distaste, and that trickles down as well. Regardless of who someone is or whatever their circumstances may be, the speech pattern, the lingo of authority, of power, will spread to others. Buzzwords quickly become a way to circumvent any actual thought process, almost cueing an instinctive reaction, as those more fortunate, those not impacted, were trained to do by this language. Horrific events and tragedies almost immediately are branded “a troubled individual’s mental health crisis” or worse still, the implication of a link to some diagnosis or another.

A good thing to keep in mind, although I’m afraid the source who inspired me seems to have slipped mine, is that when you let an individual set the language, the simplifications of concepts, on their own terms, you’ve already lost the debate.

Another element at play, that seems to build upon those motivations, is altogether too easy to describe. When one is ignorant of the impact of someone’s needs, it becomes far too convenient to place the blame squarely on their shoulders in a relationship. It becomes a toxic cesspool of proxy-victimhood and gaslighting that emphasizes that because you know someone who’s struggling, it’s clearly your own interactions with them that are a ‘severe struggle.’ I’ve seen this in dozens of smaller communities, where individuals tend to form an echo chamber, where because someone they know received a diagnosis, they themselves are in need of the most help.

As I’ve addressed both in talks to one of my former school’s BOE, and in a TEDTalk I had given earlier this year, there is one aspect in all of this that frustrates me to no end. I tend to fixate on language to a large degree, so when something is used in an incredibly inaccurate manner, I feel an urge to correct. When diagnostic terminology is used this poorly, though, it’s something else entirely…

Throughout my time in various communities, I’ve seen references meant to hurt, to joke, or simply just to convey a meaning, but regardless, these references are damaging.

Autism has been used to describe stupidity and stubbornness, Depression understated as a bout of sadness and frustration. OCD to some, simply means pet peeves, and ADHD, a minor burst of energy. BPD amounts to an excuse for poor behavior, Aspergers, the now outdated term for a subset of Autistics, being used as a vague Far Right joke. To top it all off, references to suicidality and its trend within certain demographics is used to hurt others, to end an argument. This, in particular, can be especially evident towards neurodivergent and queer folks. 

To take things a step further, a diagnosis can effectively be “over-acknowledged,” in the sense that a comparison is immediate. With those unaffected, the implication is weakness, deficiency. With those facing different struggles, it can be a suggestion of exaggeration, as if one experience is somehow lesser, and by extension, the individual is of poor character. It’s always about individuality and compassion until they face the opportunity for it firsthand. 

As I also brought up in my TEDTalk, there’s even an insinuation that anything can be risen past, or overcome. It seems to conflate the short- and long-term diagnoses far too frequently, as some have even suggested that prayer can heal and cure.

Frankly, as a species, we’d all benefit from a lot more medical knowledge. 

Building upon a prior point, I want to highlight the fact that terms and treatments have been effectively weaponized in political arenas. Anything that can stir outrage is viewed as fair game, as they play off rudimentary understanding. I will say it louder for those in the back…POLITICS HAVE NO PLACE IN MEDICINE AND HEALTHCARE.

Contributing to that outrage is a particularly disturbing spotlight. No system is without flaws, but emphasizing those flaws is not always a good thing. Misdiagnosis and malpractice are rife within medicine, and yes, it does need addressing. However, to sweep aside the experiences of those who’ve benefited, to attempt to undo that, in favor of a smaller subset instead, one that’s resentful of that failure they went through, does a greater disservice. More often than not, these failures are cast as deliberate, as if they’re part of some grand conspiracy, that usually ties into a degree of antisemitism as well. Perhaps ironically, it’s the same actions taken by these individuals’ predecessors that led to what fuels those theories. Community infighting will often result, as not everyone has the same viewpoint, the same perspective, so when someone’s scorned enough, they’ll align themselves with the opposition just to get back at another. 

Additionally, that infighting is a frequent target for others to take advantage of, as “sock-puppets” crop up, artificially inflating the number of “concerned individuals.” Any overwhelming evidence to the contrary simply gets dismissed as it doesn’t fit the narrative.

To top it all off, diagnosticians are not infallible. Some individuals may try to game the system, and as such, they can trick the practitioner into a misdiagnosis scoring themselves medications they can use recreationally. Drug abuse is a problem, but unlike the general concept that some see, it’s far more multi-faceted.

To tie this all together, and cycling back to the ignorance on part of many, there is a large unreceptiveness to new information. Whatever excuse, be it that something is “fake science” or “government-bought,” they find a way, no matter how many sources you cite, or how much data you incorporate. Perhaps ironically, this conspiratorial suspicion has very little basis, as higher-ups within standard hierarchies tend to lack that competency.

These same individuals, these “armchair experts,” may wear many faces. They could be barely-qualified individuals whose field is the exact opposite of the subject, or perhaps they’re an anonymous individual on social media. Regardless, credentials are always important, and peer-reviewing is essential.

Don’t fall down the rabbit hole, and don’t let yourself be consumed trying to refute these arguments. Sometimes, it’s better to just let them talk into the empty air, than to trot them out for refuting, granting them an audience in the process.