Say What You Mean, Mean What You Say: Stigma Around Mental Illness

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By: Cryssy Andrews, LCPC

How often have you heard or said statements such as “That is really bugging my OCD,” “You’re so bipolar,” “I’m so depressed,” “I’d rather jump off a bridge,” etc.? Statements like these are often utilized in everyday society to explain common feelings, interactions, and emotions, but can have serious consequences for people with legitimate mental health diagnoses. Over/under exaggeration can mean being afraid of someone with schizophrenia (over) or thinking that someone with depression is “just looking for attention” (under).

Whether it’s throwing labels around or minimizing real-world symptoms, misusing labels can be belittling and harmful to people suffering from any range of mental illnesses. Instead, understanding the diagnoses and symptoms of common mental health illnesses (and the impact over/underexaggerated statements have on individuals with mental health diagnoses) can help to educate and decrease stigma.

Obsessive-compulsive disorder (OCD), for example, does not refer to commonly experienced pet peeves, preferences for orderliness, or discomfort with different ways of completing the same task. In the Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition (DSM-5), OCD is characterized by:

  1. the presence of obsessions, compulsions, or both.
  2. the obsessions or compulsions are time-consuming . . . or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

When untreated, it really can take over someone’s life in truly scary ways – yet this hasn’t stopped OCD from being turned into “OCD” to describe general “neat freak” behavior. In a 2013 study to gain an understanding on the general public’s understanding of OCD, researchers from the University of Binghamton, Temple University, and the University of Arizona found that, while more than 90% of the 577 participants saw OCD symptoms as a cause for concern and professional help, only 33% could accurately label an OCD diagnosis.

If two-thirds of the general public is unaware of the diagnostic criteria for OCD, a disease affecting more than 2 million Americans, then it is clear why this illness is consistently misused and stigmatized. Allowing stigmatization to continue not only isolates individuals but shames them for their diagnosis and prevents the kind of treatment that can greatly improve quality of life.

Major depressive disorder (MDD), more commonly known simply as “depression,” is characterized in the DSM-5 by at least 5 of the following symptoms (within a 2-week period), almost every day:

  1. Depressed mood.
  2. Loss of interest/pleasure in activities once enjoyed.
  3. Excessive weight loss/gain or increase/decrease in appetite.
  4. Sleeping excessively or not enough.
  5. Feeling restless or sluggish.
  6. Feeling tired or lacking energy.
  7. Feeling guilty or worthless.
  8. Difficulty with cognitive function (memory, concentration. etc.).
  9. Suicidal ideation, plan for committing suicide or suicide attempt.

Everyone has bad days, and the feelings they inspire are completely valid to have. But when a person says “I’m so depressed” following a bad day or negative experience, they are misusing the term depressed. In looking at the discrepancy of symptoms between feeling sad and having MDD, it is clear how someone misusing the term could cause frustration or upset someone with the diagnosis. Minimizing the reality that millions of Americans live with daily not only diminishes the struggle that individuals face but can even confuse someone’s understanding of how serious their symptoms are and keep them from seeking help from a qualified professional.

Similar to MDD, bipolar disorder (I/II) is both a commonly mislabeled and misunderstood diagnosis. Often, when an individual is calling someone “bipolar” they are referring to the person constantly changing their mind or being overly sensitive or reactive. We can even hear this idea in popular culture, with Katy Perry’s song “Hot N Cold” examining the frustration in dating someone sending mixed signals by calling it “a case of a love bipolar.” In actuality, the DSM-5 states that an individual must experience a manic episode, followed by either a hypomanic episode (a milder form of mania) or a depressed episode in order to be diagnosed with bipolar I disorder. To be diagnosed with bipolar II disorder, one must have experienced a current or past hypomanic episode and major depressive episode. Criteria for a manic or hypomanic episode in the DSM-5 are:

  1. A distinct period of abnormally and persistently elevated, expansive, or irritable mood… lasting at least 1 week (manic) or at least 4 days (hypomanic).
  2. Three or more of the following symptoms:
    1. Inflated self-esteem or grandiosity.
    1. Decreased need for sleep.
    1. More talkative than usual or pressure to keep talking.
    1. Flight of ideas or subjective experience that thoughts are racing.
    1. Distractibility.
    1. Increase in goal-directed activity or psychomotor agitation.
    1. Excessive involvement in activities that have a high potential for painful consequences.

The major depressive episode that must be experienced to meet criteria for bipolar I and II follows the same diagnostic criteria as major depressive disorder.

Placing an inaccurate label on a person or an emotion can cause real damage to those suffering from mental illness. Many individuals with mental health diagnoses struggle to discuss their experience with others, often due to fear from seeing general societal misrepresentation and stigmatization of those with mental illness. These illnesses are often exacerbated due to individuals feeling ostracized from society and unable to openly discuss what they are experiencing.

A simple Google search and verification of sources is a great place to start when trying to understand mental illness. Researching this information can help fight stigma and better understand the daily reality people around us face, but it’s important to leave diagnostic labeling to the professionals. The most informative way to understand mental illness is to talk to those who experience the disorder. Direct contact and discussion with people who experience mental illnesses can help reduce misuse and stigma even more than basic research and education.

It also helps us better understand our own emotions and experiences so we can label them for what they really are: our own emotions and experiences. A simple “I’m sad” or “I’m irritable” is a surer path to wellness than a misused diagnosis.

Advocating for normalized, positive views of those with diagnoses is something everyone can do in their own life, and especially one that can be done when someone has a friend, family member, co-worker, etc. who has a mental illness. News, social media, and movies are a few platforms where misuse and stigmatization of these diagnoses is too frequent. Targeting these platforms to produce responsible, accurate information would help reduce stigma and misuse of diagnoses. A 2016 study found that people who viewed a video of someone discussing their experience with mental illness were less stigmatizing and isolating toward those with mental illness. Normalizing the experience of those who experience mental illness can remove mysticism and fear caused by misunderstanding and stigmatization.

In a society full of fear, misunderstanding, and false information, stigmatization has run rampant in the mental health community. By properly labeling emotions, educating ourselves where necessary, and understanding others who may think and feel differently than us, we reduce the misunderstanding and stigmatization of those who experience mental illness. In turn, promoting an open environment for the discussion of mental health creates the ability to improve the wellbeing of all individuals.

Individuals looking for mental health and substance use support can contact our office at 410-337-7772, or by clicking here, for more information on our clinicians, the issues we treat, and the insurances we accept to make your care as accessible as possible for you.


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