Crazy Does Not Mean Broken

Women are crazy!

It’s a common remark, especially amongst men. How misogynistic! How unfair! How demeaning! How…statistically based?

The word crazy is a misnomer, here. I’m using it in the colloquial sense, and that’s probably wrong for an article in which I am going to hurl statistics and clinical information for the next bit. By “crazy”, I refer to the state of having a mental illness.

According to the World Health Organization (WHO), there is a huge gender gap among mental illnesses worldwide. The basic gist is that women are much more likely to be diagnosed with mood disorders and men are much more likely to be diagnosed with substance abuse disorders. This results not necessarily from a “fact” that men tend towards alcoholism and women towards depression, but because of biases in the primary care providers, and social stigma. It’s more okay for a woman to say she’s often sad than it is for a man to say that. It’s more okay for a man to admit that he drinks, perhaps too often, than it is for a woman.

The most troubling part to me is the following quote:

Up to 20% of those attending primary health care in developing countries suffer from anxiety and/or depressive disorders. In most centres, these patients are not recognized and therefore not treated. Communication between health workers and women patients is extremely authoritarian in many countries, making a woman’s disclosure of psychological and emotional distress difficult, and often stigmatized.

One in five people seeking help have a mood or anxiety disorder – but most do not receive help, because the providers don’t acknowledge and treat them. If the woman outright says, “I have depression – here are my symptoms,” the provider might cause them to feel broken, inferior, unworthy. Stigmatized.

I don’t mean to go off on the providers. It’s society’s fault that the providers feel this way. Society has long stigmatized sufferers of mental illness. People with mental illnesses  used to be locked up and gawked at for a tidy profit to those running the prisons. They’re often considered “weak” or “inferior” because people believe that if they were just “stronger” or “had better coping skills” they would not be mentally ill.

This stigma exists in strength for mood and anxiety disorders – “cheer up!” and “chill out!” are society’s chosen treatments for these problems (besides immediate medication, a different topic entirely.) Those who cannot simply adhere to these oh-so-helpful regimens are stigmatized. As women are more likely to be diagnosed with these kinds of disorders, the stigma hits the female population hard.

According to the Mayo Clinic, this stigma can lead to more problems. First and foremost is that it keeps those with mental illnesses from being diagnosed and receiving treatment. It can lead to other comorbid (simultaneous) disorders. It can cause problems in living conditions and relationships with family and friends, especially if they too buy into the stigma. It can cause low self-esteem, a sense of being “wrong” or “lazy” or “broken”, and general unhappiness.

So, what can we do about this?

The best option is my common refrain: open communication. If you have a mental illness, discuss it with your loved ones, then your friends, then those around you. Describe it clinically – the symptoms, the causes, the treatment, the course of the illness. Discuss it as you would your physical illnesses. Don’t apologize for it or act like it’s an imposition on them. It is part of who you are. It is not your fault – even if it partially resulted from some bad choices. Acknowledging it and seeking help counteracts any plausible blame you might carry. Believe that you are not broken. It is not that you should work one way, and somehow got “messed up” along the way. It is part of who you are, so accept it and work to improve your life through treatment of the illness.

Work hard not to stigmatize others. Empathize and support those who have mental illnesses just as you would say “Get well soon!” to a friend with the flu. Try to understand that they are not wrong, not lazy, not at fault for their mental illness. It’s just how they are – maybe it’ll change, maybe it won’t – and you have to accept it, and offer your support for their future.

Learn the facts. Don’t listen to hearsay; go in search of information through the Mayo Clinic website and other online sources. Try to understand what someone means when they mention their problem. Try to understand their behavior in context.

Avoid labelling people by their mental illness. Don’t say “the schizophrenic down the street” – call him John, the man suffering from schizophrenia. She’s not “the depressed girl”, she’s a woman with a life and a future and a past who happens to have a diagnosis of Major Depressive Disorder. If you suffer from mental illness, do not let it become who you are. It is part of you, and that you must accept, but it is not you in your entirety. Don’t label yourself. Don’t let others label you. Just be You, as you were before your diagnosis. Only better, because you’ve decided to get help.

Fortunately, the world is changing. Mental illnesses are getting recognition as illnesses similar to physical illnesses. Treatments are out there, becoming accessible to those who have the courage and the strength (or friends/family with the strength) to seek it. It can be easy to support this on a broad level and reject it on a personal level, though – it’s the “it can’t happen to me” phenomenon. When its someone you love or yourself, it’s a whole lot more real, and makes a lot greater impact than you’d think.

So think. Anticipate. Prepare. And care enough – for yourself and others – to remember that they are people too, “crazy” or not.

Have a thoroughly satisfying day.

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