7 mental health stigmas and misconceptions that drive us mad


mental health stigmas

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Depression is not something you can just “shake off,” your boss is not bipolar and Dexter is not an accurate representation of a psychopath. We’ve put together a list of the seven common mental health stigmas and misconceptions that drive us mad in the hope of fostering more awareness of serious mental illnesses.  


1. Depression is just a bad mood, and people with depression need to suck it up and “snap out of it.”

While I realize that this misconception gets tossed around simply because people don’t have a full understanding of depression, if there’s one mental health stigma myth that makes me want to shake the misinformation out of someone, it’s this one. So many people believe that depression isn’t so much a medical condition as a personality flaw or weakness and that, if people tried hard enough, they could “snap out of it.” I promise you, this is so, so, so wrong.

Depression is a neurological disorder that most psychiatrists believe to be caused by an imbalance of certain neurotransmitters in the brain. No matter how hard one wills the feeling to go away, it usually requires therapy and often medication. Everyone has felt crappy before, so no one has a problem understanding the feeling. But those who haven’t suffered from depression are often incapable of comprehending it being as unremitting and indomitable as it truly is.

According to the Centers for Disease Control and Prevention, depression affects an estimated 1-in-10 U.S. adults. That’s more than the total percentage of both children and adults in the United States who have diabetes — 8.3%. Depression is an extremely common illness, but thankfully it’s one that can be effectively treated if the individual seeks help.

If you think you may be suffering from depression, ask your doctor for help or find a therapist, psychologist or psychiatrist. Psychology Today offers a helpful “Find a Therapist” search with which you can find psychiatrists/psychologists/therapists, group therapy or treatment centers in all 50 states, as well as Canada. For more information on depression, click here.  


2. “My boss is acting totally bipolar.”

This one bothers me in the same way that hearing people say, “I could care less” instead of “I couldn’t care less” bothers me. It doesn’t make sense! Yes, I understand what you mean when you place this politically incorrect stereotype and insensitive label on someone, but you have no idea what you’re talking about.

What you’re attempting to say is that your boss is acting erratic, and his or her mood swings are out of control. But bipolar disorder isn't about switching from rage to happiness to sadness to whatever other emotion in a matter of minutes. People suffering from bipolar I disorder, previously called manic-depressive disorder, deal with incredibly difficult periods of depression followed by periods of mania.

Researchers involved in a 2010 study published in The Archives of General Psychiatry (Solomon et al.) discovered that the median duration for any type of mood episode — either mania or depression — for people with bipolar I was 13 weeks. The depression phase includes sad mood, fatigue, sleep problems, appetite changes, difficulty concentrating, loss of interest or pleasure in life, agitation or markedly sedentary behavior and feelings of guilt, pessimism, helplessness or low self-esteem. Suicidal thinking or suicide attempts are also sometimes part of this hellish period. Then comes mania, which brings with it exaggerated euphoria, irritability, high energy, insomnia, distractibility, feelings of grandiosity, racing thoughts, excessive talking and excessive involvement in high-risk activities.

So the Boss Man patting you on the back one minute and then throwing a chair at you the next doesn’t exemplify bipolar disorder (though if he’s throwing a chair at you, it doesn’t exactly exemplify a mentally stable person either). If he suffered from bipolar disorder, he would most likely be depressed for an extended period of time and express a euphoric mood for longer than a few minutes.

And in the same way some people don’t appreciate you lightheartedly joking that so-and-so is “retarded,” it’s sometimes difficult for people who have been affected by bipolar disorder to understand how someone could joke about something so serious that has caused so many challenges for them. Not to mention you’re using the term incorrectly anyway. So we suggest finding a different way to say, “My boss is acting crazy.” Maybe try “My boss is acting so erratic that she makes reality-TV stars seem normal.” I don’t know. Get creative. For more information on bipolar disorder, click here.  


3. While conditions like diabetes and hypertension are actual medical illnesses, mental disorders are different. People with mental disorders are just “crazy.”

Though the psychology and neurology fields still have much to learn, research indicates that psychiatric disorders stem from genetic and biological causes, as well as environmental and psychological factors, according to the National Institute of Mental Health. This is no different from a medical condition like hypertension; while no direct cause has been identified for hypertension, it is believed to result from environmental factors, such as sedentary lifestyle, smoking, stress and obesity, and sometimes from inherited genetic mutations.

There’s no such thing as crazy anyway. Think about it: There’s no such thing as normal. Everyone is weird or different in his or her own way. If crazy is the absence or opposite of normal and there’s no such thing as normal, then there can be no such thing as crazy. Individuals with mental disorders are sick in the same way people with diabetes are sick; they have a chronic medical condition that is unlikely to disappear without treatment. The only difference is the part of the body affected by the condition.

4. Psychopaths are blood-thirsty serial killers who plot their murders methodically and systematically.

Hollywood LOVES psychopaths. There’s the classic “American Psycho,” the hit Showtime TV series “Dexter” and my personal favorite, the movie “Mr. Brooks.” And every legal and psychological TV series has at least one episode involving some psychopathic serial killer on the loose. If psychopaths were really all this exciting, why would we even need fictional shows about them? There would be plenty of ghastly documentaries to keep us entertained.

Before we start bursting all of your psychopathy bubbles, let’s get our terminology right. Psychopathy, sometimes also referred to as sociopathy, is currently clinically diagnosed as antisocial personality disorder. (Some people believe that psychopathy and APD are one in the same, while others believe psychopathic personality is a similar but more severe disorder. Currently, the DSM does not recognize psychopathy as a disorder, and APD is the closest thing to it. This may change in the next version, the DSM-5, which will be released in May 2013.)

The American Psychiatric Association’s "Diagnostic and Statistical Manual," fourth edition (DSM-IV), states that antisocial personality disorder is characterized by “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.” Symptoms include failure to conform to social norms with respect to lawful behaviors, deception as indicated by repeatedly lying or conning others for personal profit or pleasure, impulsiveness or failure to plan ahead, irritability and aggressiveness, reckless disregard for the safety of self or others, consistent irresponsibility and lack of remorse.

The No. 1 most common misconception of psychopaths undoubtedly is the myth that they’re all crazy homicidal maniacs. Scientific American magazine states that while antisocial personality disorder has been found to be a risk factor for future physical and sexual violence — and yes, plenty of serial killers have exhibited characteristics of the disorder — most psychopaths are not violent, and most violent people are not psychopaths. They do, however, have a tendency to commit criminal acts because of their impulsiveness, lack of remorse and self-centered thinking.

The other big misconception of antisocial personality disorder is that psychopaths are these methodical murderers who plan every detail of their crimes months in advance. The truth is that most of their crimes are spontaneous and result from their lack of control over their own impulses. They typically don’t learn from their mistakes because they’re incapable of feeling guilt, shame or remorse, so they’re unable to alter their behavior. For more information on antisocial personality disorder, click here.  


5. People with borderline personality disorder are selfish assholes, and the disorder is untreatable.

Borderline personality disorder is one of the most misunderstood psychiatric illnesses, and unfortunately it's also one of the most common, affecting approximately 1% to 2% of the general population. BPD symptoms often stem from an intense fear of abandonment and are characterized by some, but not necessarily all, of the following: mood instability; chronic feelings of emptiness; inappropriate, intense anger or difficulty controlling anger; impulsivity in potentially self-damaging areas; identity disturbance; and a pattern of unstable and intense interpersonal relationships, among others.

The idea that people suffering from BPD are selfish, manipulative jerks has probably evolved from those who have been hurt by loved ones with BPD. Recent studies have concluded that people with BPD either have a distorted sense of generally accepted social norms, or that they may not sense these norms at all, according to PsychCentral.com. This leads to behaving in ways that negatively impact trust and cooperation with others.

BPD sufferers also have difficulty seeing gray areas and tend to perceive everything as black and white, good or bad — which, as you can imagine, causes challenges in communication. People in relationships with people with BPD often feel manipulated, taken advantage of or controlled due to such BPD-typical behavior as “threats, no-win situations, the ‘silent treatment,’ rages and other methods [the non-BPD sufferer] views as unfair,” according to BPDCentral.com.

It’s important to understand that this is not intentional. BPD sufferers are often terrified of losing the loved ones in their lives; their irrational behavior is usually an act of desperation and impulsiveness stemming from the fear of abandonment. BPDCentral suggests it’s a “desperate attempt to cope with painful feelings or to get their needs met without the aim of harming others.”

It's not unusual to hear someone claim that BPD is an untreatable mental disorder, which many psychiatrists believed until research in the past decade found this to be false. Plenty of research has confirmed that borderline personality disorder is treatable, and Marsha Linehan's development of the extremely successful dialectical behavior therapy system in the past decade has drastically changed the way the field views and treats this mental illness for the better. For more information on borderline personality disorder, click here.


6. People with mental disorders just need the right pill.

There is the occasional lucky person suffering from depression who starts a medication and feels better within weeks, and that’s that. But many psychiatrists and psychologists still believe most patients' treatment requires therapy, whether the patient is also being treated with medication or not.

And, though the world of psychiatry has relatively recently become concentrated on writing prescriptions, many people have found the right form of talk therapy to be effective enough to render medication unnecessary. The fact is that it varies from patient to patient. Some people suffering from borderline personality disorder, for example, may find cognitive behavioral therapy necessary in order to correct their self-destructive behaviors that have become habitual and don’t simply disappear with the right medication.

7.  Schizophrenia means split personality.

It’s surprisingly common to hear someone confuse schizophrenia and multiple personality disorder, now known as dissociative identity disorder. The two disorders are completely different and unrelated, and schizophrenia does not include multiple personalities.

The confusion revolves around the Greek origin of schizophrenia meaning “split mind,” which was not meant to indicate split personalities but instead was meant to describe the way many people with schizophrenia are split from reality. They have difficulty differentiating between reality and the delusions/hallucinations caused by the disorder. As MayoClinic put it, “it refers to a disruption of the usual balance of emotions and thinking.” For more information on schizophrenia, click here.