It’s not so scary!

Part of the stigma surrounding mental illness is that it is scary. People hear “schizophrenia,” for example, and scenes from made-for-TV movies flood their thoughts — people rocking in the shower, episodes of violence — the actor making the internal external and obvious. Only a small percentage of those with schizophrenia (less than 1% of the population) are violent which means that the vast majority are not — despite screaming in the street. So, a generalized fear of mental illness is unjustified, as is discrimination.

Most mental illnesses do not include psychosis either (a total break from reality, the way schizophrenia does). Most people with mental illness may or may not even find their state of mind frightening. They tend to be seemingly sane people with difficulty managing their emotions and/or difficulty functioning e.g. chronic lateness to work, disturbed or restless sleep at night and fatigue and fogginess during the day, over-the-top reactions to day-to-day scenarios, extremely low self-esteem, withdrawal from social engagement, etc. Their mental state pervades and inhibits their daily life.

Also, though Freudian analysis is passe, some of its broad terminology, if taken broadly, is still helpful in understanding and destigmatizing mental illness — neuroses vs. psychoses.

A neurotic condition is, for our purposes, one of nurture over nature. If this were the “Rat Park” experiment we would ask — what was their cage like or what happened/what did not happen to this person to make them the way they are? In “Rat Park,” rats were put alone in cages with two spouts — water and a drug-laced liquid. In this setting, rats would drink from the drug-laced spout until they died. But, when given a cage with these two options, a play area, and some companions, most rats were satisfied enough with the other stimuli to avoid the drug-laced liquid. Eating disorders, for example, may have some genetic markers but they are not entirely heritable, they require environmental factors, like lonely cages, to develop. They are diseases of false beliefs about weight and worth, often a defense against trauma or neglect, often compensating for mood and anxiety disorders. Neurotic conditions, in this sense, can often be resolved or “cured” because what is learned can be unlearned.

A psychotic condition, on the other hand, does not necessarily mean psychosis is present but if psychosis is present it is automatically a psychotic condition — it’s more than “neurotic.” Instead, it means nature over nurture — that your aberrant state of mind would develop regardless of or despite your cage. You could be a clinically depressed millionaire! Hence, it is typically heritable with a very distinct and universal means or trajectory of onset and presentation. Most psychotic conditions cannot be resolved but, rather, managed throughout life — there will be relapses, there will be at least one, a few, or many permanent blind spots in your thoughts or behaviour that you need to work with or around. There is no mitigating circumstance just differing physiology — malfunctioning neurotransmitters, smaller prefrontal lobes, reduced or increased cortical activity in response to faces or emotional stimuli, etc.

NOTE: Personality disorders live somewhere between these two conditions and are permanent.

You wouldn’t tell someone with polio to simply walk it off (their bones don’t bend that way) so why tell someone with mental illness to pull up their bootstraps, cheer up, or get over it? Depression, for example, is not sadness or grief, which are circumstantial and can be resolved through time, talk therapy or modified behaviour, with or without medication. Depression can be helped by yoga, meditation, nutrition, exercise, peer support or social engagement, CBT, DBT, or medication but not “cured;” the underlying physical mechanisms remain unchanged even if the point of view has. Mental health is, in this way, physical health — brains that aren’t neurotypical.

Getting help for these conditions is also not so scary. It does not include shock treatments and involuntarily commitment unless of course meds and talk therapy do not work for you or you admit to an imminent plan to harm yourself or others. For the most part, the mental health consumer directs their own treatment plan, decides what resources they will access, and sets goals they will aspire to.

So, fear less; mental illness is not contagious and is not a death or damning sentence, just a value neutral difference between people…like height.