The Elephant in the Room

Why the fight against mental health stigma needs to be more inclusive.

How visible are mental disorders like schizophrenia, really? The stigma surrounding mental illness is still out there, even though we have come a long way since the Eugenics and treatment systems used in the Victorian style asylums. But that really is not saying much considering the fact that these were all extremely harmful practices that involved forceful sterilisation and electroconvulsive therapy. Since then, scientists have come up with medicine like antipsychotics and alternative medicine practices have come up with other solutions like the homeopathic remedies. But on a social level, where are we really? There is a strong support system online, and adolescents are much more open-minded and aware of the issues surrounding mental illness. Coming to university, I encountered a space where these issues were being addressed and discussed – be it mental health awareness weeks, talks by professionals, or just personal conversations. But this still isn’t enough.

There is a hierarchy of mental health stigma, and it arises from the fact that we’re refusing to see things that make us uncomfortable, things we cannot understand. Depression, for example, is becoming easier to talk about (even though the responses ‘oh, you’re just feeling down a little bit, it’ll pass, we all have it sometimes, etc.’ are still problematic) It is seen, at least, and the same thing cannot be said for mental illnesses like schizophrenia or personality disorders. Schizophrenia, for example, is a mental disorder with population prevalence of about 1%. In terms of numbers this is a lot, yet there is still a distinct lack of knowledge surrounding the subject. Most people seem to know this one thing about it: people with schizophrenia hear things. Portrayals of schizophrenia by entertainment media do not really help either. A study reveals that in English-language movies featuring at least one main character with schizophrenia that were released between 1990 and 2010, most characters displayed positive symptoms of schizophrenia (the ones that most people don’t experience, but schizophrenics do.) Delusions and hallucinations were featured most frequently. A majority of characters displayed violent behaviour toward themselves or others, and nearly one-third of violent characters engaged in homicidal behaviour. About one-fourth of characters committed suicide. What people have in mind when they say ‘schizophrenia’, then, is an abstract concept formed out of these misrepresentations and a culturally devised ignorance. Because people do not understand it, they fear it.

In reality, schizophrenia is a mental disorder that causes disorders of perception (though not always, depending on the type), disorder of thought, disordered speech, lack of motivation and reduced social engagement. It is not, contrary to what many people think, a multiple personality disorder; it does not mean you have a split personality that you cannot control. As Elyn Saks, a chair professor of law, psychology and psychiatry in the USC School of Law, and also someone with schizophrenia, informs, ‘the schizophrenic mind is not split, but shattered.’ Even though the label is new, account of schizophrenia-like symptoms can be found in ancient texts dating far back to 2000 BC. Examples of these are the ancient ‘Egyptian Ebers’ papyrus, the ‘Hindu Arthava Veda’ (dating approximately 1400 BC) and a Chinese text called ‘The Yellow Emperor’s Classic of Internal Medicine.’ In the shamanic tradition, babbling confused words, dancing wildly, and being “tormented by spirits” are common elements in shamanic initiatory crises. Such crises are interpreted as a sign of an individual’s call to be a shaman: they think if the illness occurs in an appropriate cultural context, the shaman recovers from this crisis fully and starts healing others. While modern medicine sees only the negative consequences of suffering, shamans see it as a process of purification and a significant transformation in consciousness. Schizophrenia is something that has always been there, in one form or another; and it is a certain illness that makes an individual’s life much more lonely and difficult- but it does not have to be something that prevents them from living a life they want and certainly not something that defines them solely.

What we can do to break this stigma surrounding these mental illnesses is to increase our awareness, to try to understand (try, being the key word- the effort is what makes it constructive) and to be more careful in our use of language: Mental disorders like schizophrenia and personality disorders are stigmatised to such an extent that they have infiltrated into our daily use of language. People ask each other ‘are you schizophrenic?’. Because I like to keep my room tidy and clean I’ve been told many times to ‘stop with my OCD.’ These uses are not helping; on the contrary, they are reinforcing the stigma and shame that surround this subject. By using them in this mocking manner and reducing these difficult realities to colloquialisms, we are saying ‘I don’t really understand, and I don’t care to understand.’ We must talk about this, but in a much more inclusive way.  Only by breaking the silence and the indifference surrounding the stigma of all mental illness can we really contribute to the wellbeing of people and create an inclusive environment for all.
[Gonca Yalcin]

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