Our society stigmatizes people who suffer from mental illness to avoid examining the public policies that ignore the emotional well-being of those most at risk.
Last week the Washington Post ran a version of my last Role Reboot column on how a nervous breakdown helped me to come to terms with my Facebook addiction. Excited as I was to see one of my own articles in a national paper, I was pained to discover, when I first looked over the post, that several dozen commenters had already weighed in with the consensus that I am a “nut job” who really needs to get out of her parents’ basement.
As a woman whose ex-husband once posted a 5,000-word article detailing why he believed her to suffer from borderline personality disorder, this popular excoriation hardly came as a surprise, though a stinging one nonetheless. But it still prompted a question faced by many other writers who’ve dared to talk about their mental health in a self-compassionate way: When someone calls you crazy in an attempt to stigmatize and silence you, how can you respond?
Lucky for me, I’d just had the chance the week before to meet the writer Andrew Solomon, author of several TED Talks and books on mental health, when he stopped by my city (which, I’d like to point out, is several thousand miles from my parents’ basement) to give a talk at the Hay Festival Medellín.
Solomon has made a name for himself as a champion of society’s most marginalized groups with books like The Noonday Demon: An Atlas of Depression and Far From the Tree: Parents, Children, and the Search for Identity that push readers to examine their reflex to stigmatize people who live with depression, deafness, autism, schizophrenia, Down syndrome, and other exceptional conditions. He aims to help us understand and advance in our “universal struggle toward compassion.”
According to Solomon, compassion is precisely what’s needed by every person who struggles with mental well-being (that’s one in four people globally, according to the WHO): compassion toward ourselves, and even compassion toward the people who believe we are nut jobs whose voices should be suppressed. Being compassionate toward oneself involves making a commitment to look for meaning in your own mental distress; in Solomon’s words, “thinking, when [the depression] comes again, ‘This will be hellish, but I will learn something from it.’”
But Solomon’s analysis remains vague on how to react compassionately toward those who stigmatize sufferers of mental illness—and the role that such stigmas play in protecting the policies that cause the least well-off to suffer disproportionately from such illnesses in the first place.
Solomon advocates a highly medicalized, therapy-oriented approach to treatment of mental disorders, seemingly oblivious to the fact that such a treatment regime is almost completely inaccessible to the billions of people worldwide with patchy or nonexistent access to physical and psychological healthcare, expensive pharmaceuticals, paid medical leave, or a stable family support structure. And given that, as the WHO points out, “persistent socio-economic pressures” are one of the most important causes of mental disorders, this means that the people most likely to suffer from mental illness are also the least likely to have access to the care they need—and be stigmatized for it, to boot.
In fact, it’s no logical stretch to surmise that underlying the stigma from people trying to silence the mentally unwell is fear—fear that such people won’t “fit in” to established structures for their care and will thus become a social burden that many citizens, social-Darwinist style, would simply prefer to see disappear.
In a brilliant recent article over at openDemocracy, editor Ray Filar pointed out the destructive results of this contemporary politics “in which labor market potential is all that makes a person worthwhile”:
The silence and social stigma around mental health is deliberate, the product of an institutional refusal to talk about the affective impact of socio-political conditions. Some people get depressed, or psychotic, we think, because of chemical imbalances or individual traumatic experiences. They’re just lazy or making it up. We don’t talk about austerity, poverty, demonization of the unemployed—the politically-driven stigmatizing of the least privileged groups of people—but is it any wonder we’re unhappy?
In other words, stigmas exist to protect a status quo that tells us: If you’re mentally ill, it’s nobody’s fault but your own. And if you’re mentally well…well, that must be due to your own cleverness/goodness/responsibility/hard work, too, right?
Or as Filar puts it: “‘Hard working families’ [cling] to the myth that misfortune stems from a lack of hard work…[and] feel justified kicking down against the less well off.”
Luckily, researchers have begun to give more attention to the political roots of emotional well-being—and in doing so, are defusing the power of those who would stigmatize the mentally unwell. Even Andrew Solomon, whose research on depression has mostly focused on its non-political determinants, included an entire chapter on how class affects depression in his book The Noonday Demon.
The World Health Organization, for its part, has heavily emphasized the connection between poverty and mental disorders, and advocates a rigorous program for promoting mental wellbeing that goes far beyond medications and therapies to push for support for children and the elderly, socioeconomic empowering of women, housing programs, and a stronger safety net in general.
I certainly can’t say I initially reacted to the seven dozen Washington Post commenters calling me a nutcase with a compassionate (and dispassionate) understanding of the conservative deployment of mental health stigma in society. But the analysis of writers like Andrew Solomon has helped make one thing clear: Stigmas gain their power from making people feel shame. But shame cannot survive in the face of individual and collective compassion.
So I’m now trying to make this choice every day: Let the compassion begin with me.
Samantha Eyler is a freelance American writer, editor, and translator based in Medellín, Colombia. She has written about politics, immigration, Latin America, and social justice for publications such as NACLA and the New Statesman. You can follow her on Facebook and Twitter.