By Rosie Alger

Elm Staff Writer

What comes to mind when you hear the words depression, OCD, anxiety, bulimia, ADHD, schizophrenia? We’ve heard the words before. We’ve been taught not to use them lightly, but when can we use them at all? Mental illness is a subject that not a lot of us know how to talk about. What does it mean to be a person with a mental illness? How do you define where the line is between just going through a rough patch and really needing extended support? According to NAMI, the National Alliance on Mental Illness, “One in four adults−approximately 61.5 million Americans−experiences mental illness in a given year. Approximately 20 percent of youth ages 13 to 18 experience severe mental disorders in a given year.” This is only the cases that have been documented, and yet our societal conversation on the subject continues to be clouded with shame and uncertainty. I think it is time that we change the nature of our conversation, and open it up to an honest and inviting discussion of why these conditions are so common and what we can do about it to support one another.

The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is the basis for psychological diagnosis in the U.S. and across the world, and even the slightest changes in its definitions can drastically change who is diagnosed or how they are categorized. For example, a lot of people are familiar with the latest edition of the DSM’s alteration of its definition of Autism to the Autism Spectrum. This led a great shift in our understanding of autism and how it affects the daily lives of people struggling with various levels of the disorder, but a side effect of the change is that it left many people with legally documented disorders that no longer existed. Some found their continued treatment and accommodations more difficult to attain with the change in the label.

I use this example to highlight the fluid nature of our understanding of mental disorders and illnesses. While it is extremely important to understand that mental illnesses are just as much an illness as  physical ailments are, a more dynamic and engaging conversation on the subject would also talk about how important it is to understand how changing and hard to define mental illnesses can be. If the manifestations of these illnesses are very personal, existing largely only in the brain of the individual, how can anyone know for certain that their thoughts are more than the average amount of stress, or more than just a situational problem. Doctors and experts can help in this endeavor, but if we are trapped in our own heads to realize there might be a problem, will we ever go to the doctor in the first place to get a diagnosis?

Even beyond that, medical treatment might not be for everyone. If you are a person who needs more therapy than pharmaceutical treatment, you may not find the label of a diagnosis extremely helpful, and you may be even more hesitant to reach out for one. NAMI also states that “Approximately 60 percent of adults, and almost one-half of youth ages 8 to 15 with a mental illness received no mental health services in the previous year. One-half of all chronic mental illness begins by the age of 14; three-quarters by age 24. Despite effective treatment, there are long delays−sometimes decades−between the first appearance of symptoms and when people get help.” Why is there this huge disconnect between experiencing the symptoms and getting treatment? The answer is complex, but I think a large part of it has to do with the stigma surrounding mental illness, which is two-fold. We are afraid to admit that we might have a mental illness for fear of seeming weak, and we are ashamed to ask for help lest we feel guilty for overshadowing someone whose mental illness is more “real” than our own.

On a personal note, I myself have struggled with symptoms of anxiety, depression, and disordered eating and been too afraid or ashamed to admit that I might have a real problem. Even in the midst of episodes of self-harm I found myself justifying my silence by thinking to myself, “You’ve never been diagnosed with anything. You can’t just call yourself depressed for attention.” I don’t normally like to talk about my own battles with mental illness, but I mention this in order to demonstrate how easy it is to think that you don’t “qualify” as someone who deserves help or recognition for your suffering. Given that these conditions stick in your head, it can be a common side effect of the illness to convince yourself to feel guilty for needing help.

Ultimately, while those labels and diagnosis can be enormously helpful and necessary to some, not having one does not make you less worthy of help for whatever you are going through. In fact, if those people who have the diagnosis of chronic mental illness had remained silent about their experiences, they would never have seen a doctor and gotten the diagnosis at all, and their struggles would still be unknown. Not only does reaching out for help open doors for you personally, but it also furthers the larger conversation of our understanding of how mental illness affects us all. In order for there to be any improvement on our current system of treatment, which is widely acknowledged to be lacking on many levels, we have to first grasp the enormity of the number of people whom mental illness affects. We have to be honest with ourselves and as a society about how big of a problem mental illness is and fundamentally change the way we look at why so many of us have it and what to do about it. That understanding starts with individuals admitting to themselves that they can’t handle it alone. In the end, you are never alone. If you need someone to talk to, contact local emergency hotlines or make an appointment with Washington College Counseling Services, who can be reached at 410-778-7261.

The Elm

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