Desigmatized

Destigmatized Working to remove associations of shame or disgrace

Mental Health issue no. 1

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Published March 2020 Typeface used : Mukta Mahee regular 10pt

IBM Plex Sans thin 12pt and bold 18pt

A note from the Editor Mental illness is all around us, whether we know it or not.

Those with a diagnosed mental illness can be your neighbor, family member, friend or even you. It affects children, adults, men and women. We live in a society that makes it difficult to live and thrive with a mental illness because of the stigma around it. It is looked down upon, criticized, valued less and even dismissed.

We live in a society that tells us to “get over it” or “it is just a phase,” even though people’s lives are crumbling inside and they are afraid to ask for help. People suffer in silence every day because of the way we judge mental illness. We do not judge people for having diabetes, asthma, or cancer, and we would never tell those people to just “get over it.” Why do we do that to people with depression, bipolar disorder or anxiety?

I think as a society we need to change. We need to change the way we think about mental illness and the way we talk about it. Education is the foundation of any change. Better education in schools is one way we can start to help people understand mental illness. We need to teach people that mental illness can be caused from a chemical imbalance in the brain, traumas or major life events. It is not necessarily just someone having a rough patch.

Teaching people how to recognize when someone may be struggling and then encouraging them to seek help can be the support someone needs. This can help others feel like they are not alone and that it is not uncommon for individuals to struggle with their mental health. No one should ever feel like they are wrong for taking medications or going to therapy to improve their mental illness. Although you cannot see mental illness on the outside, it does not mean it does not exist. An individual’s mental health is just as important as their physical health. I believe that small changes will eventually lead to a big shift in the way mental illness is looked at in our society.

Add These to Your Feed…

@marcelailustra Brazilian illustrator Marcela Sabiá posts enthusiastically on the topics of self love, mental health, and body positivity. She’s all about owning your mental and physical health issues. She’ll make you appreciate the skin you’re in.

@SadGirlsClub The account is managed by Elyse Fox, a well-known indie filmmaker and mental health activist who has been an influential voice around mental illness in the west. While Sad Girls Club has around 32k followers, Elyse, herself, has about 20k followers and uses her social platform to raise awareness.

@Project 1 in 4 A digital project started by Marissa Betley, Project 1 In 4 is a creative organisation dedicated to fighting the stigma and raising awareness around mental health in a way that brings real life stories to the front. The Instagram account has over 11k followers and aims to get followers to relate through the minimalist sketches.

Contents Where Does the Stigma in Mental Health Come From? 5 See the Bigger Picture 6 Should I go to Therapy? 12

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Black Ink Marina González Eme ink on paper

Where Does the Stigma in Mental Health Come From?

by Emily Olsen

Taking the first step in admitting you have a mental health problem and need help can be difficult. The stigmas surrounding mental health can make it even harder. Mental health stigmas often lead to various forms of exclusion or discrimination at work and within your circle of family and friends.

Stigmatizing beliefs about mental health are shared by a wide range of individuals within society, regardless of if they know someone with a mental health condition. Adolescents with mental health problems may face stigmatized behaviors from family, peers, teachers, and school staff. Adults may experience stigma from friends, family, coworkers, and employers.

Stigmas associated with mental health issues come from misguided views that these individuals are “different,” from everyone else. Early beliefs about what causes mental health issues included demonic or spiritual possession, which led to caution, fear, and discrimination.

Society has stereotyped views about mental illness and how it affects people. The role of media in mental health stigmas also cannot be denied.

News reports often link mental illness with violence or portray those with mental health issues as dangerous, criminal, evil, or disabled –often in television shows and movies.

A mental health stigma can be social or perceived. Social stigmas often lead to prejudice or discriminating behaviors. Perceived stigmas are internalized stigmas. A person with mental health issues may begin to perceive themselves a certain way as a result of the discrimination they endure.

Perceived, or internalized, stigmas can cause feelings of shame, lead to isolation, and a distorted self-image. Internalized stigmas also make people less likely to seek out treatment and disclose their mental health condition.

Based on the Center for Disease Control’s 2012 “Attitudes Toward Mental Illness,” negative stigmas on mental illness can lead to embarrassment and fear in disclosing mental health problems, which can prevent treatment and recovery. Negative stigmas can also result in limited life opportunities, such as limited employment and housing opportunities.

When it comes to mental health stigmas, knowledge is power, as is challenging these stigmas. Mental health stigmas will not simply go away on their own.

By working together, a community of advocates can change the way mental illness is perceived in society.

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See the Bigger Picture Interview by The Bigger Picture in London, England Attitudes towards mental health problems are improving, but common misconceptions are leaving some conditions behind. It’s time to see the bigger picture.

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Antonio photographed by Adam Stevens

Antonio There’s a limitation on who you can tell that you have schizophrenia - especially being from the BAME community. Not everyone understands schizophrenia or thinks it’s a real thing. Some people might think it means having a split personality, but it’s not like that. When I was hospitalised, rumours started being spread about me. What I’d told one person changed as it was passed from personto-person…before I knew it people thought I was dangerous. I was a popular person, but my big circle of friends started to become small, as some of them said I’d ‘fallen off’. There’s a black cloud surrounding schizophrenia which follows me everywhere. You see people with mental health problems in strait jackets and doing violent things in movies, so people start to think you’re like that. Others think we use our diagnosis as a way of avoiding accountability. If everyone had a choice, no one would choose to feel or act as if they had a mental health problem - so it’s just not true.

I started to hallucinate. I was hearing voices and I was always paranoid people were looking at me. The voices told me people were talking about me. When I heard those voices, I tried to challenge them, denying what they were telling me, but they were too overpowering. When you hear voices, it makes you feel bad about yourself - I was upset with myself, not other people, and I never wanted to hurt anyone. I felt so bad about myself that it consumed me - I didn’t even think about other people. The voices stress you out and when other people spread rumours, it adds to that stress. I was

fighting a war in my own head. It was against me not other people - and I was trying to fight it alone.

I started to learn how to recognise the voices, how to challenge them, and then I started to understand and become more aware of them. I try to distract myself when I hear them now by listening to music, doing mindfulness - putting myself in a happy place. If I give myself too much space to think and ruminate the voices become stronger. If I feel pressured or things get too much, I put my headphones in and listen to the UK top charts which helps to slow down my thoughts and block out the voices. I lose trust in myself daily. Every day I have to tell myself I can trust my mind. I used to have this idea that, because I have a mental health problem, I should limit myself. I created a barrier, but others helped to build it around me. People put down your capabilities and say you should to do things which are ‘easy’, but you don’t always have to take the easy route. I like to challenge myself, because it’s only when you come out of your comfort zone that you start to grow. It hasn’t been easy. I’ve had to start university twice now because of my mental health. When I returned, my head was saying ‘you’re not ready’, so I had to push myself to take the next step. I wanted to stay in my bubble, but I trusted my mind, and now I’ve broken free.

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Billie photographed by Adam Stevens

Billie Initially when I was diagnosed, I was thrilled. I identified with the symptoms and my diagnosis meant I could finally get help, but when I googled borderline personality disorder (BPD) it was horrible to read how people talked about us. I read articles about how to get out of a relationship with someone with a personality disorder, how ‘toxic’ we are and how to spot us. It made me feel too ashamed to tell anyone for a long time.

Recently, a friend of mine set me up on a date. When I met him, he said ‘I googled you and asked my friend why she had set me up with a crazy woman. But I guess everyone has something…” I felt disgusted. I never spoke to him again. I appreciate it comes from a place of ignorance but that attitude can make some people give up. Its heart wrenching to hear things like that. I have spent four years campaigning, going to recovery meetings and going to endless therapy so it’s horrible that there’s still that attitude.

I have a great career - recently I’ve been working as head of PR at a law firm and managing crisis publicity for a well-known celebrity - intense, high-pressured work which I know is not what people sometimes imagine from someone living with such a debilitating mental illness.

Some people think you’re manipulative, sneaky and reckless because of the BPD symptoms. They wonder what is really going on and say certain things about you being hysterical or dramatic. If I’m acting in a certain way, it’s usually because I’m feeling abandoned and it triggers that behaviour. Personality disorders can come from abuse, neglect or abandonment and so some people learn these behaviours to survive a difficult childhood – but these behaviours can turn bitterly destructive in adulthood.

Typically, people think if you’ve experienced BPD you can’t have healthy relationships. I was in a relationship for eight and a half years! I think it makes some people lose faith in themselves. They believe the stigma and become more isolated and suicidal. Stigma is costing lives.

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I don’t think ‘personality disorder’ is an appropriate term. It fuels the stigma and suggests your mental health problem is fundamentally your personal responsibility. It makes it sound like you don’t have a personality, or that your personality is bad. The people I have come across with BPD are some of the kindest, most empathetic people I have ever met.

I struggled with intrusive suicidal thoughts throughout my teens and twenties. It’s not constant, but that’s been really horrible. The depression used to be so bad that I used to struggle three or four days a week to do anything – I couldn’t even text my family back – I completely isolated myself. When things were really bad I was very self-destructive. I used alcohol and recreational drugs to try to manage the symptoms, but of course, it just made it worse.

I now go to weekly support meetings and enjoy chatting to people like me who have experienced BPD. I do radical self-love.

Swapping toxic coping mechanisms with positive rituals which are good for me – I have a nice bath now, go for a walk or call a friend instead of having a bottle of wine and losing myself in risky behaviour like I used to.

I’ve been off medication for a few months now and I’m feeling happy and stable. Therapy has been a life saver and I don’t know where I’d be without it. I wish I hadn’t waited so long to get help...but the positive thing is that help is available and it does help immensely.

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Jason photographed by Adam Stevens

Jason Any diagnosis of a mental disorder is frightening, but so too are those crushing depressions when you can’t function, the times when life is simply too much or when you are simply out of control. It was after my second suicide attempt that I was diagnosed with bipolar disorder. The crushing, life draining, depressions I had noticed (obviously), but somewhere down the line I seemed to have missed the mania. Unfortunately those around me hadn’t and they had to deal with the mess that was left.

For me there was fear, but there was also a sense of relief, and at last I knew there was a reason for the way I felt and something I could try to fight. However, the initial thoughts are that if you have a mental illness you will be locked away in an institution, lobotomised, and your life is over. Those thoughts are based, not on what the reality is, but on society’s perception. A perception based upon generations scared to accept what is different and quite happy to lock it away – and literally throw away the key. You need to realise that your life is not over, in many ways it is beginning again. Once you realise that then you can accept the illness. You can accept treatment and you can live.

Sadly there were people close to me who believed these misconceptions and whether through a lack of understanding, fear that it was contagious, or simply shame, they distanced themselves and could not deal me having a mental illness.

These were not just friends, or even close friends they were close family. Sadly it included my brother.

It made me feel frustrated, having to bottle in who I was and how I felt. Nothing should be bottled in, especially when you have a mental illness.

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When I speak to people and tell them, happily and with no shame, I have bipolar disorder, then often their reaction is I don’t look mentally ill, whatever that means.

Thankfully, there have been those who have stood by me and learnt with me how to deal with bipolar disorder; my wife, my family, my friends. Especially my wife, who has fought every battle with me since my diagnosis. Initially her reaction was relief, like me, and the hope that that there was a “cure”. Now we know there isn’t a cure, a magic pill, but we can fight it together. But it is not just her support, or that of my family and friends, as the more I talk and then the barriers come down and the stigma erodes.

I still get depressed, I still have days when I don’t want to leave my bed, crawl under the sheets and hide from life. I still have days when I feel “wrong”. But I have support, my condition is well managed at the moment, I remember to take my meds and my life is good. I have a beautiful family, I have a good professional job, I can talk to people and I function. I have a normal life despite being mentally ill.

A mental illness does not define you.

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Should I go to Therapy? By Crystal Raypole It may take some consideration before you decide you’re ready for therapy. You might want to wait and see if time, lifestyle changes, or the support of friends and family improves whatever you’re struggling with. If you experience any of the following emotions or feelings to the extent that they interfere with life, therapy may help you reduce their effects.

It’s especially important to consider getting help if you feel controlled by symptoms or if they could cause harm to yourself or others.

Overwhelm. You might feel like you have too many things to do or too many issues to cope with. You might feel like you can’t rest or even breathe. Stress and overwhelm can lead to serious physical health concerns.

Fatigue. This physical symptom often results from or accompanies mental health issues. It can indicate depression.

Fatigue can cause you to sleep more than usual or have trouble getting out of bed in the morning.

Disproportionate rage, anger, or resentment. Everyone feels angry at times. Even passing rage isn’t necessarily harmful. Seeking support to deal with these feelings may be a good idea when they don’t pass, are extreme compared to the situation, or if they lead you to take violent or potentially harmful actions.

Agoraphobia. People with agoraphobia fear being in places where they might experience panic attacks or become trapped.

Some people may become unable to leave their houses.

Anxious or intrusive thoughts. It’s normal to worry about things from time to time, but when worry takes up a significant part of your day or causes physical symptoms, therapy can help you deal with it.

Apathy. Losing interest in usual activities, the world around you, or life in general can indicate mental health issues like depression or anxiety.

Hopelessness. Losing hope or motivation, or feeling as if you have no future, can indicate depression or another mental health condition. Feeling hopeless from time to time, especially after a period of difficulty, isn’t uncommon. But when it persists, it may lead to thoughts of suicide.

Social withdrawal. Many people feel better when they’re able to spend at least some time alone. Introverted people may need even more time alone than others. But if you feel distressed around others or fear being with other people, therapy can help you understand and deal with these feelings.

W magazine esom, Rala Choi

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SAMHSA’s National Helpline 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/ or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

Artwork by Casey Miller

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