Not Just Sadness...

When you work in the mental health field, people talk about the stigma against mental illness and its treatment frequently. As with most things, I think that those with a disposition against mental illnesses and their treatment simply haven't taken the time to truly learn about and understand mental illness. During this first week of October, which is deemed Mental Illness Awareness Week by congress in 1990 to honor the work of National Alliance on Mental Illness (NAMI), I'd like to take a moment to get back to the brass tacks of mental illness.

People throw around terms like depressed, bipolar, narcissistic, and sociopath without even knowing what they really mean. There seems to be an ever increasing temptation to "diagnose' those around us who might be different than what we expect them to be. I heard a friend of mine the other day say, "She must be bipolar or something" when referring to another parent that all those present knew. I asked if she had gone back to school to get a degree in a mental health field. She looks at me like I'm being ridiculous and says, no. I say, "Well then we probably shouldn't go around putting a really serious diagnosis on someone that we don't really know." It is easy to assume that because someone has a personality trait that you dislike, there must be something wrong with them. In all my training and all my experience in mental health, nowhere has it ever said that the criterion for a diagnosis is that you find someone annoying.

Mental illnesses are serious disorders in which there is a difference in the makeup of the chemistry in one's brain. Everyone experiences a range of emotions. Some days I feel sad. No real reason, I just do. I may not feel like getting out of bed, but I can get out of bed. I may not feel like going to work, but I do go to work. I may not feel motivated to do my other daily activities, but I can force myself through it and do them. Many people mistake the days they feel like this as being what someone with clinical depression experiences. What most of us feel as part of our normal range of emotions is significantly amplified for someone who experiences depression. There is a whole list of symptoms to meet criteria for to be diagnosed with depression under the Diagnostic and Statistical Manual (DSM). The DSM is the manual that is used by clinicians to diagnose a mental illness. People who are depressed not only feel a change in their emotions, but also in their physical health. Depression literally impacts their whole self. Some of the symptoms that clinicians look for include: change in weight, change in sleeping habits, fatigue, loss of interest in things that used to give them pleasure, feeling worthless or helpless, indecisiveness, inability to concentrate, thoughts of death, psychomotor retardation (means they literally move slower), and feelings of sadness, depressed mood, and/or emptiness. They need to experience this set of symptoms for at least two weeks. Two weeks is a really long time to feel this way! When I have these days of sadness, I can do what many people tell someone with a mental illness to do. I can "fake it until I make it". Or I can "just pull myself up by the bootstraps and deal with it". Someone with clinical depression cannot do those things. The chemistry in their brain does not allow them to just move on with their day in the same way. A combination of medications and therapy are what is recommended. A person living with depression, has to work on functioning how must of us do without thinking.

I used depression here as an example and I will spare you the details of going through all the other major mental health disorders. What message I'd like to send home with you today, is that there is a significant difference between what the "average" person experiences as part of their normal range of emotions and what a person with a mental illness experiences. This does not make them less of a human being. This does not mean that they don't have good skills to cope. This doesn't mean that they are less strong. This means that they have a different chemical makeup. Next time, instead of giving advice, ask how you can help and let them know that you care. A little kindness, patience, and understanding goes a very long way.