On August 20th the Brattleboro Reformer published an article about the Brattleboro Retreat's Annual Ride For Heroes, a motorcycle rally and fundraiser for the hospital’s Uniformed Service Program. On that day, Windham County Sheriff Keith Clark did a courageous thing: he publicly shared his story of experiencing a major depression, his decision to seek treatment, and his consequent recovery. As I read his account I found myself saying: Thank you, many times.
That’s because most of us do not comprehend what major depression is really like. Imagine experiencing an agonizing numbness or agitation, a loss of a felt sense of worth, a mental fog coupled with an inability to concentrate or use your mind well, a grave hopelessness expanded by immobilizing fatigue, suicidal thoughts, dread sleep disturbance, isolation and/or alienation. These are just some of the symptoms of this mood disorder.
Telling someone experiencing a major depression to "pick yourself up by your bootstraps" or, for a person struggling PTSD to "get over it", is like telling a runner with a broken leg to "just rise up and finish that marathon." We can see and appreciate the casted leg. But we often do not see or understand the signs and symptoms of a mental illness— sometimes because people feel lost within, profuse shame, and cannot show outward signs of their suffering.
Yet mental health is as real and authentic as any other aspect of one's health. The National Institute of Mental Health (NIH) reported that in 2015, 16.1 million adults suffered an episode of major depression in the previous year. That’s 6.7 percent of the U.S. adult population. And depression is only one of the myriad of ailments that can affect our brains, our psyche, and our minds.
Now imagine this: in addition to experiencing the pain of mental illness, another layer of anguish must be confronted—that of being stigmatized. Stigma is a Greek word that stems from a historical time when criminals, slaves, or traitors were branded to identify them as morally defective and therefore to be shunned. Stigma is a form of prejudice and stereotyping. Those suffering from mental illness know this, and it is one of the saddest reasons many do not seek help.
Like all prejudices, stigma arises in part from our own fears, vulnerabilities, lack of knowledge, and misunderstandings. We are all prone to some forms of prejudice; and anyone who claims they have no prejudice is not looking deeply enough. Many stigmatizing perceptions and beliefs are unconscious. The different "other" may represent an unexamined and irrational threat to our safety. We project negative attributes to the 'other' to provide safe distance from our fears and wounds.
So is it fair to equate mental illness with weakness? To address this question we need to differentiate illness from character. Would we think someone struggling with cancer has a questionable character? Yet, many feel differently regarding mental illness. People may have strong or weak characters, completely independent from any physical or mental condition. Mental illness arises from vulnerabilities due to the interplay of genetic, biochemical, relational, and environmental factors, not personal weakness.
As we observe Mental Illness Awareness Week (the first week of October) I imagine a day when mind and body are seen for what they are—an integrative system of human wholeness. And in addition to our primary care providers (family doctor, pediatrician, or internist) we have another type of PCP—a primary care mental health provider that we also visit for an annual checkup. And when we experience mental distress, we work together to explore, clarify, diagnose, and determine further treatment.
There is good news: we have more mental health specialists working together in physician offices. More people are speaking out, including many well-known individuals who have a broad reach and can be role models. We have multiple organizations dedicated to mental health like NIH, NAMI, the American Foundation for Suicide Prevention, the Substance Abuse and Mental Health Association (SAMSHA) and many more.
And just when the road ahead seems long, someone like Sheriff Clark shows up and walks through the door seeking mental health treatment—this time not leading others in need, but for himself. So to Sheriff Clark, who sought help and spoke out, and to those before and those after who have and will do the same...our deepest gratitude. Thank you for standing up to stigma and taking us another step closer.
Jilisa Snyder, Ph.D., is Clinical Director of the Brattleboro Retreat’s Anna Marsh Clinic