Categories
Schizophrenic.nyc

Stigma and the Media

Stigma doesn’t just disappear – it only gradually fades, or, God forbid, gets worse. A recent U.S. News article presents research that suggests that both are happening in the U.S. right now. The study examines various representative samples of over 1,000 U.S. adults and their perceptions of depression, alcohol dependence, and schizophrenia in 1996, 2006, and 2018. Over the years, it appears that Americans’ “mental health literacy,” or understanding that mental illnesses are medical conditions, has improved. In addition, Americans in 2018 were less likely to avoid people with depression, which is a good sign. On the other hand, though, attitudes towards alcohol dependence and schizophrenia are worsening, with around 60% of the 2018 sample viewing the former as a character flaw and around another 60% viewing the latter as an indication of being “dangerous.” These changes could be attributed to the increase in high-profile figures and celebrities openly talking about their struggles with depression, or the prevalence of antidepressant ads, both of which could help “normalize” depression. Conversely, however, the media portrayal of alcohol dependence and schizophrenia helped perpetrate negative stereotypes. For example, the recent spike in gun violence has prompted people to erroneously fabricate a relationship between mental illness and violence.

This article demonstrates just how much of an impact media can have on people’s stigma. Media is also a double-edged sword – while it has the power to reduce people’s stigma, it is equally disposed to increase it. It all comes down to how we use it. Given media’s important role in public opinion, it is the responsibility of the distributors to be mindful of potential impacts. I’m definitely not arguing for restricting free speech in the media; that would obviously be unconstitutional. What I’m saying is that media producers should watch out for the effects of their media outside of the intended effect. For example, media coverage of gun violence is not intended to stigmatize mental illness (though if it is, that is a different issue). Thus, news organizations should make sure that the way they portray violence accounts for the potential stigmatizing effects. That said, doing so is much easier said than done. A more immediate solution would probably be to counter the negative effects of the media with mental health advocacy – something that is already being done, by people like Michelle. As history has shown us, though, advocacy by itself only gets us so far and it is necessary for our institutions and the government to expend effort towards the goal of reducing stigma.

Categories
Schizophrenic.nyc

Forced Treatment and the Law

Anosognosia (uh-noh-suh-noh-zha), or a person’s inability to recognize that they have a mental illness, affects an estimated 30% of people with schizophrenia and 20% of people with bipolar disorder. It is not denial; rather, it is hypothesized to be a condition caused by disorder in or damage to the frontal lobes. People with traumatic brain injuries, for example, sometimes have anosognosia. Anosognosia is very problematic, as it emotionally harms loved ones who want the person with anosognosia to get treatment, and it also harms the person with mental illness, who feels frustrated and alienated by the people around them trying to convince them that they are sick. The typical solution for this problem is forced treatment. A recent Seattle Times article dives into the policy of mental health care and anosognosia. Washington State has had a very tenuous relationship with mental health care, at one point forcing patients into overcrowded hospitals. Thus, to avoid another such fiasco, policy has reversed and Washington is now one of the hardest places to get forced treatment, and the only way to get someone with anosognosia treatment is to prove that they are a danger to themself or others. The article argues that the system’s libertarian focus is blind to the needs of people who literally are incapable of making informed decisions about their mental health, and change is necessary. 

This article confronts (and also explicitly acknowledges) a very salient topic in the world of mental health. What are the rights of people with mental illnesses? Michelle, for example, has had very unpleasant experiences with forced treatment, having been strapped down and forcibly injected with sedative at a psych ward. On the other hand, it is true that for some people the only way to get them treated is forcibly. Where do we draw the line? Washington state drew that line towards the free choice end of the spectrum, though the article is arguing for a relaxation of laws restricting forced treatment. I believe, however, that the answer lies in neither. The solution is greater individual attention towards people with mental illnesses. Nobody tried to explain anything to Michelle when she was in the psych ward, which greatly frustrated her. I can’t speak for Michelle, but I think it would have been less unpleasant if someone had sat down with her and asked her what she thought. From there, they could have decided whether she needed further treatment or not. 

The key word here is equity – it is an inherent flaw of policy that every person is different, and so has different needs. This is no less true for mental health care, and yet this topic has not received the attention and funding that it warrants. People with mental illnesses need treatment that is just right for them, which for some people is forced treatment, and for others is not. We need to stop thinking of mental illness as a monolith, and start viewing it as no different from the other topics that dominate policy. Ideally, every person with a mental illness should be able to talk with an expert and have a say in their treatment (or no say, if their anosognosia is too complete). Of course, nothing in this world is ideal, as policies are fundamentally limited by reality and are merely approximations of the ideologies behind them. Still, simply talking more about mental health is a step in the right direction. If we can put ourselves on the right path and keep walking forward, that is enough.

Categories
Schizophrenic.nyc

The Name Game

Will changing the name of a mental illness help de-stigmatize it? A recently published New York Times article describes a survey designed to build momentum for the name change. 

The name “schizophrenia,” meaning “split mind” and coined in 1908 by Dr. Eugen Bleuler, was not intended to have negative connotations. However, it has taken on a stereotype of “dangerous” or “amoral.” Schizophrenia has been misunderstood and appropriated as an insult. Doctors are reluctant to diagnose people with schizophrenia because it is such a loaded word, and people who do have it are reluctant to seek treatment because of the stigma. Now there is an organization trying to reduce these associations by changing the name of the disorder. 

There is undoubtedly harmful and unreasonable stigma surrounding the term. However, I don’t think that changing the term will achieve anything. It is comparable to changing a filter: it is shiny, new, and relatively problem-free soon after it is installed, but it does not withstand the test of time. The original term “schizophrenia” was coined on a scientific basis, and yet it has still been muddied by the public consciousness. Why wouldn’t the same happen for a new term for schizophrenia, especially since public stigma is just as bad, or even worse than it was soon after it was coined? The negative perception of schizophrenia attaches itself not just to the name of the disorder, but also to the people living with it. Even discounting the logistical difficulties of changing the name of a disorder, the change is not worth it. It only treats the symptoms of the problem, not the cause. The best route to destigmatizing mental illnesses is to create content, just as Michelle is doing, to demonstrate that schizophrenics are just as human as a “normal” person. Through first-hand experience (albeit through a screen), the true nature of schizophrenia overrides the stigmatized perception drawn from popular culture and the tabloids.

Categories
Post

Stress and Mental Health

Too much stress is bad for you. This fact may seem obvious, but it isn’t as obvious as you may think. A recent NYT article examines research which demonstrates the risk that stress presents to heart health. The recent studies demonstrate that psychological stress may play just an important part – possibly an even greater part – in heart health than physical stress. This is true not just for people with underlying heart conditions, but also for people with completely healthy hearts. Stress triggers the release of hormones which, over time, increase blood pressure and promote atherosclerosis, a condition that commonly underlies heart disease. The article also suggests ways of reducing stress, such as exercising, activities such as yoga or mindfulness, and some medications.

            As a student, I have often felt guilt for taking breaks or procrastinating. I felt that feeling stress was equivalent to productivity – which was in some situations true, but for the most part constituted for me a huge source of undue stress. For me, part of this subconscious belief comes from popular culture and portrayals of irresponsible, tomboy students shirking work in order to go and fool around with their friends. In order to be praised as diligent, I would actively try to defy these stereotypes, which is to say I would try to avoid having fun. I know someone whose father told them that they were not allowed to have fun until they got into college. The other half of this problem is the stressful modern environment, which emphasizes success and unrelenting hard work as a sort of gospel. We’re always told to do our best, but what is “our best?” Is it working until we don’t feel like it anymore, or is it working until we literally drop? We aren’t really given a choice in this matter. Nobody is telling us that we are not allowed to take breaks, but the modern culture is implicitly telling us so. That is why I hate the word “hedonistic:” it is a disparaging word which could easily be applied to people who simply value their mental health, which to me is a fundamental right. This is just the stress from my privileged standpoint, where all I have to worry about is succeeding academically. There are millions of others who have to deal with all of that on top of other stressors, such as financial insecurity. 

            The point of this rant was to demonstrate that modern medicine has fixed many of humanity’s physical ailments with its wondrous vaccines and medicines, but unhealthy mental habits are not just still present, but are also getting worse. The mounting stress of the COVID-19 pandemic, for example, is literally destroying our hearts, and the stress of the modern world has been killing us for quite some time. The field of medicine is already starting to turn its attention to this topic, but when will policy finally acknowledge the gravity of this crisis? I’m not trying to suggest that there is a silver bullet to this problem, nor that is it a problem that cannot be solved. As I have repeated ad nauseam, what mental health warrants is international attention. It should not just be treated like a health problem; it has to be viewed as a fundamental human right and deserves a spot in the pantheon of social justice, alongside race, gender, socio-economic status, and religious belief, among other things. People disadvantaged by, for example, systemic racism, experience more stress than the average white person (look it up – there are so many studies done examining this relationship). Mental health is not unrelated to all of these things, and it is high time that we realize that.

Categories
Post

Mental Health and Social Media

At first glance, there is no obvious connection between TikTok and mental health. However, as a brief WYNT article warns, TikTok can influence teens to self-diagnose themselves with ADD/ADHD, OCD, anxiety, and depression. Therapists have seen a rise in teenagers claiming to have one of the above disorders. The issue here is that teens are using the word too lightly – feeling anxiety is not equivalent to having anxiety disorder. Of course, the article then lapsed into a discussion of TikTok and security threats, but the message is still there: what do we do about the public perception of mental health, especially when it comes to teenagers?

            Considering that today’s teenagers are experiencing a mental health crisis due to the pandemic, misinformation mishaps due to social media are the last thing we want. By so glibly throwing around words like “anxiety disorder” and “depression,” influencers undermine the actual weight that these words carry. Although it is a good thing that mental health is receiving more attention is this manner, the attention it is getting is desensitizing the teenage public to the gravity of the mental health situation in our country by reducing it to a few offhand comments about a teacher’s annoying grading policies. Depression is much graver than that. The voices of the teenagers who are actually suffering from anxiety and/or depression are being drowned out by the voices of those who don’t have it – some of these TikTok users are actually suffering from a mental health disorder or simply trying to offer their thoughts on mental health, but it is impossible to tell who it is when there are so many others crying wolf. In addition, the misinformation surrounding mental health can prevent teenagers from identifying when these mental health disorders actually appear, either in other people or themselves, because they have a skewed perception of how it manifests. It’s not that TikTok is an evil institution (which is arguable, but I will shelve that argument), it’s how people use it which can be harmful.

Categories
Post

Children and Mental Health

A recent opinion article in the New York Times lays bare the mental health situation in our country. The author is a child and adolescent psychiatrist experiencing unprecedented patient volume. One of his patients, who is 11 years old, has panic attacks whenever she wears a mask. Many others have expressed—or acted on—suicidal thoughts. Adolescents are suffering from overwhelming anxiety and depression. Even before the pandemic, mental health care was precarious. There was (and still is) a psychiatrist shortage, with the national average number of psychiatrists at less than 25% of the average recommended by the American Academy of Child and Adolescent Psychiatry. Many schools, especially, are shorthanded when it comes to mental health care. As a result, less than half of the children in this country receive adequate mental health treatment. The advent of the pandemic has only intensified these problems, with mental health clinics (both in person and online) saturated and overburdened.

            What will our future look like if this generation’s mental health is defined by the stress and trauma of the pandemic? The solution is simple: we must pour our resources into mental health institutions. As the author of the NYT article argues, the mental health care system should be substantially expanded, a process already begun by SAMHSA. Even so, the unending influx of public health advisories and pessimistic pandemic outlooks, whether political, economic, or medical, drown out the voices of mental health experts. There is still not enough attention towards mental health care, which was egregious even before the pandemic, when many were struggling with inadequate resources. As I have reiterated many times, the pandemic is a case study for what happens when our flawed healthcare system is put under stress, and a clarion call for the world to finally face mental health head on.

Categories
Post

Government Announces Funding to Address Mental Health Crisis

The Substance Abuse and Mental Health Services Administration (SAMHSA) recently announced that it would be providing $3 billion in services to address the mental health crisis our country is currently facing due to the effects of COVID-19. In addition, a federal board will be assembled to effectively distribute these services across the nation. The events of the past few years have undeniably contributed to the ongoing crisis, with anxiety, depression, and substance abuse on the rise. In addition, the pandemic has exacerbated pre-existing inequities in mental health, with African-American and low-SES households suffering more acutely from bereavement and unemployment, and Asian-Americans experiencing increased hate and discrimination.     

            The steps that SAMHSA is now taking to address mental health represent a huge leap forward. Not only is the new initiative an acknowledgement of the importance of the mental health effects of the pandemic, but it addresses the pandemic’s intersection with existing societal constructs such as race and socioeconomic status. The convening of a board demonstrates not just federal attention towards, but also proactive participation in this under-appreciated aspect of healthcare. Of course, mental health is not just an issue during the pandemic. Rather, it is a pervasive problem that has been festering for a long time, as the world transitions to the digital age and people struggle to keep up with the rapidly accelerating change marking our societies. Without a doubt, one unexpectedly positive outcome of the pandemic is that it has turned global attention to mental health.

Categories
Post

A COVID Christmas

This is our second Christmas since the onset of the COVID-19 pandemic, but experiencing the holiday during the pandemic is more stressful than ever, as a recent New York Times article points out. The virus and its variants, inflation and economic hardships, and the traditional family fiascos that accompany the holiday season are all piling on, resulting in a not-so-merry Christmas for many families. Simply visiting relatives has become an ordeal, with COVID-19 tests in heavy demand and family members disagreeing over vaccination. The Times suggests that for single women, the struggle is even more fraught; the fluctuating severity of the pandemic has introduced a pervasive uncertainty and a return to agoraphobic tendencies born from the early months of lockdown. Indeed, since Thanksgiving therapists have seen a rise in clients, many of whom are suffering from near perpetual anxiety and fear due to the combined influences of the holidays and COVID-19.

            The pandemic’s disruptive effect on the holidays demonstrates the dire realities of the mental health situation in this nation. During the daily grind, it is easy to chalk anxiety and stress up to the hardships of work or school life. However, during the holidays, when individuals should be finding space to relax and recuperate, the pandemic is relentlessly adding stress to their plate. The situation will only continue to worsen as the pandemic drags on. Obviously, as the NYT article asserts, holidays are far from stress-free, but there are certainly much more stressful events we must prepare for, such as the loss of a loved one or a period of unemployment. The anxiety that people are experiencing now due to the combined stressors of the renewed virus and the holidays is only a foreshadowing of what is to come if we do not address the issue of mental health.