By 
In every culture throughout history, there have been people operating in the “mainstream,” and folks that have been deemed outsiders. Anybody seen as “other” is at risk of being shamed and judged. Think of religious and ethnic minorities, non-cisgender heterosexual individuals, and people who are in some way ill.
I’ll give you a recent example. In the 1980s, HIV/AIDS was thought to be a virus that only homosexual people could get. The mysterious disease hit the LGBTQ community especially hard. The media seized on this in their coverage and ignored other groups desolated by the illness. Whether it was intentional or not, leaders in politics and media stoked fears of this unknown disease as a gay person’s problem. The result? When somebody had HIV/AIDS, they not only had to carry the weight of an incurable, deadly illness, but also the judgment of society. As a result, people avoided getting tested, hid results from friends and family, and withdrew entirely.
Opinions have changed in recent years. Treatments have become more effective. There’s a lot better information out there around HIV/AIDS. Scientists have published a lot of good research showing how the virus could get transmitted. Pop culture figures like Magic Johnson came out and redefined what it meant to have the virus. Whether through media or personal experience, people now know better what it means to be HIV positive.
Unfortunately, although it’s gotten better, stigma around having HIV/AIDS persists.
Such is the story of mental illness in America. People experiencing psychiatric symptoms frequently blame themselves. Depression often gets mistaken for laziness. Anxiety may look like cowardice or weakness. For a variety of reasons, people perceive mental illness as a moral failure. If these symptoms last long enough, somebody might even think this experience is a core trait of who they are.
When one zooms out and looks at the big picture, though, they may see their experience a little differently. Over the course of this article, I will argue to you that mental illness is a condition.
Before we begin, you should know how we got here.
A Brief History of Mental Health Stigma
There have been campaigns throughout history in trying to promote the humanity of a person in psychological pain or disorder. Think back to the pushes for reforming and ultimately closing down the psychiatric asylums. These facilities maintained awful living conditions, but the general public only found out through media like the novel and film One Flew Over the Cuckoo’s Nest. Once society recognized the injustice of that system, they acted in overhauling it. More recently, we have pushes by organizations like National Alliance on Mental Illness (NAMI) during Mental Health Awareness Month, or Los Angeles County’s “We Rise” campaign, each of which try to give relevant information and resources. These kinds of organizations work tirelessly to lift the burden of shame that people with mental illness carry.
Still, we have a long way to go.
Everybody knows someone with a mental illness. A study from November 2020 shows that 51 million, or about one in five American adults live with mental illness. So how is it that this shame can be so sticky, so unshakable, in the United States and around the world?
For one, it’s hard to understand or fully appreciate the length to which the chains of mental illness can ensnare us. If you broke your leg, I wouldn’t ask you to run a marathon. In fact, if I asked that of you, you may point to your leg and ask what the heck I’m thinking.
We understand much easier what’s going on with medical stuff. We can reach out and touch a cavity. A scan of our body can show us a tumor. Mental illness, on the other hand, can be much more invisible. Looking at a person, you can’t necessarily see anxiety. There isn’t any blood test that shows depression.
People often don’t recognize or understand mental illness. They may just think there’s a problem. If you can’t push yourself to get out of bed, maybe you’re lazy. If you’re so anxious or worried that you can’t even read a sentence without drifting into your thoughts, they think perhaps you’ve been cursed. When you can’t stop thinking about a horrible moment in your past, you must be weak. Maybe even crazy.
Each of these explanations peddles in shame and guilt, often blaming the suffering person for things that aren’t even their fault. Well, I’m here to tell you the science is clear. Mental illness is a condition like arthritis or the flu, not a personal failure.
Here’s why:
Reason #1: Mental Illness is Rooted in Biology
Take it from the National Alliance on Mental Illness (NAMI): “Like arthritis, diabetes, cancer, and heart disease, mental illnesses are usually biologically-based disorders and may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination.”
Earlier, I called mental illness invisible. While that’s true for the most part, there are many ways psychiatric symptoms affect our biology.
Under a lot of stress? If you had your blood drawn, you might get back that your cortisol levels are high. Cortisol is the hormone associated with stress. Dealing with high levels of cortisol—IE high stress—can break down immune systems and get you sick more often.
Having a low level of serotonin can lead to chronically feeling low or sad. Exercise and good nutrition can help with your serotonin levels, by the way. So can antidepressants.
Did you know there was a study showing MRI scans of people’s brains as they experienced emotional pain? The brain lit up in the same places as they experienced physical pain. The conclusion? Hurt is hurt. There’s even been some evidence that taking Tylenol may help ease the pain. Mental illness is a condition that can be recognized like any other medical phenomenon.
Reason #2: Anybody Can Become Mentally Ill
More people deal with mental illness than you might think. The National Institute of Mental Health, a real authority in this field, estimates that 25% of women and 16% of men experience some sort of psychological disorder in the United States. That estimate might be low-balling the men, by the way—a lot of experts believe men tend to downplay and underreport any kind of mental illness condition.
About 29% of young adults experience some sort of mental illness. That number dips down a bit for adults 26-49 (25%) as well as 50 and older (14%). Biracial adults are more likely to report mental illness (32%), followed by white adults (22%).
Regardless, about one in five Americans experience mental illness.
Think about what that means logistically. If you’re in a room of twenty people, four of them may have mental illness. In fact, during the pandemic’s bleakest moments, at least 40% of adults experienced depression or anxiety.
These numbers have been talking specifically about the United States, but it’s a bit hard getting enough numbers from other countries to generalize. There can be wildly different cultural interpretations of what constitutes a mental health issue. However, it’s generally agreed that other developed countries tend to have a lower rate of mental illness. Put that in the back of your mind and we’ll circle back to it.
Nobody knows for certain why mental illness starts. There is no virus to blame. Instead, the idea scientists have is that everybody has a unique potential to become mentally ill. Some of that is genetic. For example, disorders like depression, bipolar, and schizophrenia have genetic components. If you have a parent with mental illness, you’re at greater risk of developing it yourself. But not everybody does.
Above all, the biggest factor is stress. Experiencing prolonged or acute stress—think of a loved one dying, struggling in college, immigrating to a new country—may activate underlying potential for mental illness. This is one reason why you often hear mental health providers like myself stump hard for self-care and getting rid of stress wherever possible.
Why do some people get mentally ill and others don’t?
This is a big area of study right now. Psychologists are scrambling to figure out what makes some people resilient to incredible stress, and others more vulnerable to lasting psychological injury. Protective factors like a good support system and healthy financial resources make it so somebody is more likely to cope successfully. Risk factors for the start of psychological disorder might be things like having a medical illness and isolation, for example.
So why do Americans experience a higher rate the mental illness condition compared to some other countries? Nobody knows for sure, and there are probably a lot of practical explanations. Some may suggest that other countries don’t screen mental health well, and while that might be true in some cases, it doesn’t totally capture it.
In my view, this idea of stress activating mental illness is one of the better explanations. There are some fundamental systems in the United States, like university education and healthcare, that can cost huge sums of money. Student debt or a massive hospital bill can cause enormous stress. Regardless of one’s political affiliation or personal beliefs, other nations’ people don’t face these kinds of costs.
If you don’t trust that systemic issues can amplify stress and mental illness, just think back to the early days of the COVID-19 pandemic. As lockdowns changed people’s ability to work or hang out with loved ones, mental illness skyrocketed across the world. This was an extreme, earth-shaking situation, but smaller changes in a person’s life can have seismic effects on their mind, too.
Reason #3: Incredible Feats are Accomplished by People Living with Mental Illness
You’ve probably heard of the Hallelujah chorus from Messiah. Listen along and you’ll probably recognize.
Back in 1741, George Frideric Handel wrote the entire 260 page oratorio in 24 days. That’s right, one of the most famous and beloved pieces in classical music was written in less than a month.
Documents show Mr. Handel had what was then called manic depressive illness. We now refer to that condition as bipolar disorder. He experienced periods of incredible highs, where he could stay up for days with little sleep and be incredibly impulsive and productive. However, he also experienced depressive periods, where he could hardly move or function at all.
Some of the most important contributions to society come from people living with mental illness. While their conditions brought particular struggles, these individuals were able to survive and even thrive through their journeys. We often get told that mentally ill people are sad, dangerous, or otherwise burdens in society. Their stories and successes are not always familiar. I hope to fight that stigma by using space on this blog to honor some of the accomplishments of people living with mental illness.
Conclusion
If you’re reading this and you live with mental illness, please be kind to yourself. Your struggles are not personal failings. It just means you have extra weight attached to your legs as you climb the mountain.
If you’re stressed out, try engaging in self-care. I have a whole explanation on the practice of self-care here. Or try improving your sleep. And if you’re having a hard time, please consider reaching out to a local provider for treatment. Working with a group, therapist, and/or psychiatrist can be a great opportunity to get your symptoms under control.
This site will continue putting out content fighting against stigma. Mental illness is a condition, and should be respected as such. If you’re interested in keeping up with posts like this, as well as other information around mental health, please consider subscribing to my email list. You’ll get a free worksheet to track your mood and see how you’re feeling throughout the day.
