Fighting the Stigma of Mental Health

Mindful Healing_Fighting the Stigma of Mental Health

Stigma refers to the negative social views that are associated with a particular circumstance or quality. Within the realm of mental health, this is the feeling of, or negative perception about, a person with a mental health issue. Stigma is so pervasive that it is built into our colloquialisms; statements like “he’s crazy,” are used to describe bad behavior, which then creates an association between bad behavior and experiencing a disorder. This is unconstructive and can lead to discrimination both towards others and the self. Stigma creates many complications and misunderstandings about mental health.

Consequences of Stigma

Stigma can present a number of issues. For one, it makes people less understanding about other people’s suffering or conditions or causes people to blame others for their conditions. Let’s use another colloquialism to demonstrate this process. The phrase “she’s just anxious” can be used to dismiss the reactions of someone who experiences an anxiety. There are some major implications to that statement. It ascribes the characteristic of the disorder to define the person. We don’t describe someone diagnosed with cancer as “she is cancer” or someone who currently has the flu as “she is flu,” because we don’t blame the person for their health condition. The more proper phrasing that eliminates blame is “she experiences anxiety.”

The research shows some other jarring data about stigma. In addition to creating blame, negative views, and misunderstandings about mental health, it also causes people to ostracize those with mental health issues and isolate them. Research also shows that increased stigma makes mental health conditions worse. Sociologists and anthropologists have observed that societies that are more accepting of those with mental health issues tend to have people who have less severe symptoms and easier recoveries than societies with less acceptance.

Another challenge with stigma is that it is not just an external process towards others. We internalize stigma, which means that if we ever experience a mental health condition, we ostracize ourselves for having a health problem. Stigma is one of the primary barriers for those seeking help because not only do they have to deal with the challenges of mental health issues, they experience shame for having one in the first place.

Why Do Stigmas Persist?

There are lots of reasons. Part of it is that in a history of misunderstanding, the science of psychology is very young in Western society. The notion that mental health disorders are stress reactions is relatively new. The history of mental health has historical stigmas, misperceptions, and other prejudices that are passed down from generation to generation. The main book for diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, used to have homosexuality as a diagnosis despite it being a very normal part of our diversity in sexuality.

Another challenge comes in with public education and awareness. Despite the fact that we, as a species, all have different capacities and challenges with our abilities to think, emote, and process, mental health is not a normative subject in any K-12 program or even in universities. Some notions of mental health disorders and what they are have only just begun to enter the public perception.

Another contributing factor to stigma comes from our model for treating mental health issues. Like the vast majority of health issues in the United States, the funding for treatment of mental health disorders comes via health insurance statistics. Health insurance companies presently operate on the “disease” model of mental health, rather than viewing it in a holistic manner. In a disease model you either (1) have a disease and are unhealthy, or (2) you don’t have a disease and are healthy. However, the science shows that mental health disorders are likely normal stress reactions to unhealthy circumstances, rather than an unhealthy process. For a great essay with more details click on why disorders are not diseases.

Another source of stigma comes from the multi-billion-dollar pharmaceutical industry. Let’s unpack that loaded statement. First, there is massive stigma towards pharmaceuticals in general that prevent people from taking helpful medication. Pharmaceuticals have a role in mental health in creating adjustments to disordered neurochemistry and is not a reflection of anything right or wrong with a person. They help a lot of people and I am of the belief that people should take them if they help lead to a healthier, better life. The problem is in the campaign to medicate misery and anxiety as a whole. Uncomfortable emotions are major communicators that tell us about our world, environment, and needs. The notion that one is experiencing depression, trauma, or anxiety and, thus, is unhealthy is untrue. Learning how to understand and process our feelings and learning to adapt to our environment are important developmental milestones that lead to long-term healthier outcomes. Misery is not a sickness.

There are other major sources of stigma and this blog does not have the room to address them all. Culture, family, and knowledge are all intertwined. Just remember, fighting stigma starts at home. The more open and honest you can be about your own mental health, the more capable you are of offering courage and understanding for others to do the same.

Common Incorrect Prejudices Against Anxiety and Depression

It is important to identify misconceptions and realize why they are inaccurate. There is the notion that people suffering from depression lack willpower and need to pull themselves up by their bootstraps. Another misconception is that people suffering from anxiety have a weak personality, lack courage, or are just indecisive. There is no truth to either of those statements and the mentality of “just deal with it,” does nothing to actually fix legitimate psychological struggles. Anxiety and depression are not due to a lack of willpower or weakness. Nobody chooses depression or anxiety. There is strength to those who are surviving their struggle, and courage to working through it.

Coping with the Stigma

Begin with awareness. It starts with learning to differentiate between what are common misconceptions as opposed to what reflects reality. Know that whatever you’re experiencing or that others are experiencing isn’t due to some huge flaw but the result of some sort of internal reaction to environmental factors. If you are struggling with a mental health issue, you may experience fear of labels or judgment. If someone you know or love is struggling, you may struggle with your judgments towards that person’s plight. Those experiences of fear are ok and natural; how you respond to it will help determine the outcomes. Being able to work through fear and accept that what is going on is real, and not a reflection of value, is huge. Being able to lend a compassionate hand and listen to what’s going on can also make a big difference. Get treatment for anxiety or depression. Stigma doesn’t only come from others; you must fight your own stigmas. You are not alone, and you don’t have to be alone. Also, do not identify yourself with your own depression or anxiety. We are much more than the issues that challenge us.

 

If you live in Portland or the Portland area and want information or help with Anxiety Disorder and/or Depression,

E-MAIL US OR CALL US AT 503-878-8588 TO SCHEDULE YOUR INTAKE TODAY.

 

Negativity Bias, Running Late, Anxiety, and Mindfulness

I woke up to my alarm for the 2nd time that morning feeling groggy. It was two hours earlier than I normally would wake on a Friday, and yet I was running late; whoever invented the snooze alarm is an evil genius. I hate running late, though it’s a situation I often find myself in. My mind began to focus on some solutions to my time problem: just have some cereal for breakfast, skip a shower, move faster, and eat faster…things like that. I sped into to the kitchen to make breakfast and discovered there was no coffee in the house. Who’s supposed to function in the wee hours of the morning without coffee? A friend needed a ride to an important appointment and I needed to make sure they got there on time. And with each misstep that morning I could feel the tension increasing in my traps, and the need to move faster. Unfortunately while operating at this pace I was making more mistakes, wasting valuable time. And then, I couldn’t find the keys. The tension was overwhelming. My mind started racing through worst-case scenarios. What if they missed their appointment because I hit the snooze, or couldn’t find my keys? That would be my fault, and would make me a terrible friend. And what would happen to them? The tension in my traps felt more intense and spread throughout my body, my jaw got tight. I felt like I couldn’t contain it. “Damnit” I shouted in frustration…Anxiety is a powerful force.

Fast forward to an hour later. I drove to my friend’s place and got to them on time. Traffic was light that morning and I dropped them off at their appointment with 20 minutes to spare. All of those catastrophe scenarios my mind generated suddenly seemed so silly in retrospect. I could breathe, my trapezius muscles could soften, I could finally relax and was on my way to getting myself a well-earned cup of coffee. In reflection it is pretty easy to see that my response to anxiety that morning was not very helpful except for causing me some distress.

Breaking down this situation: here’s how much anxiety I would like to have felt given the totality of the situation.

JS hits MW slow mo

And here’s how much anxiety I experienced.

MW hits JS

Ah the absurdity of being human.

JS MW Laugh

That morning I was not very mindful. I disconnected from the present moment and allowed my mind to pull me into worries of the future, and ponder catastrophes yet to happen. It also pulled me towards the past with my critical mind, “if you only didn’t press that snooze button you wouldn’t be running late. Why didn’t you check to see if there was coffee yesterday?” My mind went to blaming. “If you weren’t making so many stupid decisions in the past, you wouldn’t be in this position now. If my friend didn’t need a ride, I wouldn’t be in this mess.” I also allowed my feelings to control me, reacting to the powerful hormones of anxiety by hurrying up, getting into flight mode.

We humans have a negativity bias. We naturally connect with experiences and thoughts that tell us that we are in danger more than ones that tell us we’re OK. Danger can mean many things: for our ancestors, that could’ve meant a large predator in the wilderness. In the modern era danger can be a car rolling through a stop sign, a fight with our partner, a work deadline, or running late for a meeting. Evolutionary psychologists call our propensity to be on guard for danger the false alarm effect. A great way to think about this process is like having an internal fire (danger) alarm. If a fire-alarm is extra sensitive and it goes off when it’s not supposed to it can be a nuisance at worst, but it doesn’t place your survival at risk. If a fire alarm isn’t sensitive enough and it fails to alert you to a fire, your survival is at stake. Thus it makes sense that we evolved to have a more sensitive alarm for danger instead of a dull one. When our alarms go off, regardless if the danger is due to a large jungle cat, fire, or running late, our fight-or-flight response activates increasing physical tension and narrowing the focus of our minds.

Complicating matters is the fact that the mind is a compelling story-teller. It tells us stories all throughout the day. Sometimes it daydreams ridiculous stories of possessing magical powers, or rehearses the big meeting coming up. Other times, it likes to catastrophize, magnify, minimize, judge and blame. It can weave tales of black and white about a rainbow. It told me I was a bad friend because I hit a snooze alarm, it told me that for sure my mistakes would cause my friend to miss court. In Acceptance and Commitment Therapy, we say that when our mind tells us a story, it changes our perception of reality, and we have fused with that thought. When you disconnect from that thought, it is called defusion.

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That morning I fused with the story that “I am running late, I need to move faster.” And I reacted to that fusion with anxiety. Common physical symptoms of anxiety include increased heart rate, tension, gastrointestinal issues, tingling, numbness, sweating, clenching, panic and/or goosebumps. Typical psychological symptoms of anxiety include: racing thoughts, worry, catastrophic thinking, self-criticism, poor self-confidence, apprehension, problems with decision making, and/or fear. Some of the common behavioral reactions to anxiety include: avoidance through distraction, substances, staying away from reminders of the anxiety, suppressing thoughts, or substance use. Other reactions to anxiety include: rushing, pacing, nervous laughter, combativeness, or working extra hard to compensate for the feelings of anxiety.

In essence, our minds are prone to seeing the world in a more negative light, restricting our focus from seeing other perspectives, create stories that may enhance those negative perceptions. In response—to believe the stories your mind tells you—your body releases a series of hormones which make it more difficult to defuse from the story. Suddenly you get a vicious self-feeding cycle. That morning, I rushed through my morning routine due to anxiety, and as a result I made more errors, which led to an increase of the anxiety. I was so focused on the negative that I couldn’t see the blanket truth happening in the world around me.


So how do we manage our minds when they combine negativity bias and compelling stories? Well for starters, we can stop minding our minds. With mindfulness, meditation, yoga, or other mindbody practices we can learn to take the observer role, learn how to ground, notice that thoughts and feelings can be inaccurate, and they happen automatically. When we develop such skills we develop the power to choose which thoughts and feelings we want to engage with, and how we want to react to them. Mindfulness is an active practice that can be used throughout your lifespan. Mindfulness isn’t a cure-all that means we can achieve a state of being that removes us from human paradoxes and drama, but it helps a lot.

Other ways of managing mindbody reactions include taking active self-care to reduce our psychological vulnerability to unhelpful frames of mind. When our mindbodies are in peak health, they adapt to stressors with more flexibility, creativity, and ease. Peak health is often achieved by having good nutrition, regular exercise, sufficient sleep, feeling safe and secure, relaxation, managing stress, and satisfying our social, psychological, and physiological needs. When I gave my friend a ride that morning, I was sleep deprived and I also did not participate in exercise that week. Those factors made me more vulnerable to having an intense anxiety reaction compared to when I experience similar stressors of running late when I’m well rested and exercise regularly throughout the week.

Today, we explored some of the nature of anxiety. The human mindbody is sensitive towards danger signals, and responds by activating our fight-or-flight system. Additionally, the mind is a compelling storyteller and it can tell us tales of disaster, judgment, or catastrophe. And when we aren’t in peak health conditions, we’re more vulnerable to unhelpful frames of mind. Anxiety is experienced through physiological, psychological, and behavioral responses. Mindfulness activities, stress management, and self-care can help us manage our responses to our internal systems and give use more power to choose how we want to react to what is happening in the here and now. Thank you for taking the time to read this article dear reader. Until next time, farewell.