As a physician specializing in psychiatry, I know that many emotional conditions such as depression and anxiety disorders are true medical illnesses with a biologic (physical) origin. Psychiatry has become more and more “biological” in its diagnosis and treatment approaches during recent years, but a very significant stigma still exists against those who are seeing a therapist. This has become increasingly difficult to understand, but it is a social stigma that is so very important to eliminate.
Why does an embarrassment or stigma still exist associated with those who are seeking psychiatric treatment? Why do people wait so long before come for help – to the point of becoming nearly non-functional with their families, children and work environment?
First, many people have a picture in their mind of movies in which psychiatrists are ineffective listeners of problems of patients who are lying on psychoanalytic couches. It is important to remember that psychoanalysis preceded our modern treatment approaches which now have a much higher success rate. We currently have many safe and effective medications, which when used with or without psychotherapy, help many people fully recover.
Another reason for the stigma is in the use of the term “mental illness”. The field of psychiatry has undergone many changes in the past twenty years. Research into the functioning of the brain and nervous system has led to the concept of a “chemical imbalance” as the cause of illnesses such as Major Depression and Panic Attacks. In addition, Obsessive Compulsive Disorder, a condition portrayed so well by Jack Nicholson in the 1997 movie “As Good As It Gets,” is also caused by a chemical imbalance. Medications were used to help treat the “Obsessive Compulsive” character being played by Nicholson. Many psychiatric illnesses are not “mental” or “emotional,” but are now understood to be “neurochemical illnesses”.
Many people are told, “You can do this on your own, be strong,” as if a person can easily will themselves out of depression or anxiety. Can someone “Be Strong” and make their diabetes or bronchitis just go away? These types of suggestions only result in a delay in seeking treatment or feelings of failure in the individual who finally does seek help. The stigma of psychiatric treatment also leads many people to seek help at the health food store, or other types of self-diagnosis and self-medications.
Men in particular have to overcome an additional obstacle. It may seem “Un-Macho Like” to seek professional psychiatric help when one fails to understand or see their condition as an illness, and instead view it as a weakness in their character. Thus, injury to a man’s ego often contributes to their long delays in seeking treatment.
My hope is that the shame and secrecy associated with obtaining professional psychiatric help will gradually diminish and eventually cease to exist. If we understand how the social stigma was established in the first place – the media lack of medical knowledge, societies’ understanding or ignorance, etc., then we should realize there is no need to “stay in the closet.” Let’s wipe out the term “mental illness” and view many of these conditions as “neurochemical illness,” with the same non-prejudicial attitude as we do toward diseases such as diabetes or hypertension.