The Stigma Of Mental Illness

With a certain amount of glee, I tell people "I'm mentally ill." The discomfort on their faces is almost palpable. Most people are shocked to hear those words, especially coming from the likes of me: I graduated from Harvard Law School and I have practiced law for more than 10 years. On the outside, I am a successful person. Yet, like my brothers and sisters on the street, I am "mentally ill"-whatever that term means.

I'll tell you what it means to me. I have a mind that does not function like those of my peers. I have severe mood swings. Most of the time, those swings take me to a land of dark nothingness and fatigue. Other times, I have bursts of energy that enable me to outwork all of my colleagues. These mood swings are accompanied by changes in demeanor that perplex those closest to me. I can be cheerful, energetic and personable. Other times, I am coldly analytical, with no patience for those who deign to differ with my opinions. Finally, it means being so sick of the rollercoaster ride that death feels like the only option.

I started on this desperate ride in childhood, and it continued through my early years as a practicing lawyer. Eventually the pain became too great and I, reluctantly, sought professional help. With the assistance of a skilled psychologist and a psychiatrist, I learned that my problems were threefold: alcoholism, traumatic childhood experiences and a biochemical mood disorder that requires medication. Although the first two problems are substantial, each worthy of an essay, the third carries a stigma that can be damning in itself. The shame of recovery from alcoholism, while still present, has been minimized. It is almost fashionable to be in a 12-step recovery program. In some circles, therapy is quite acceptable and sometimes encouraged. But it is another thing to proclaim that one is taking psychiatric drugs.

Even though certain brave members of the arts and entertainment industry have come forward to share their experiences with psychiatric medications, the shame in mainstream America prevails. Several years ago, a nurse told me that she dropped out of a therapy group because there were too many "crazies"-some of them even took lithium! (Unknown to her, I take lithium.) Some of my recovering brothers and sisters maintain that a person on psychiatric drugs is not "clean and sober." This perverse philosophy is reinforced by social agencies caring for the less fortunate; in my city, most halfway houses willingly accept recovering alcoholics and addicts, but not those taking psychiatric medications. When I told one of my lawyer co-workers about my "problem," he was markedly uncomfortable. Later, he wanted to know how I was doing, but expressly requested that I not mention the "gory" details. People wanted to know why I sometimes seemed so sad. But they are not ready for the answer.

When I started down the road of psychiatric medication, I was quiet and embarrassed. I was afraid of condemnation. I felt shame when I went to the pharmacy and filled my prescriptions. However, the pain was so great that I was willing to try anything. I could not go on living as I had been. The bouts of penetrating despair were bringing me to my knees and suicide was a looming reality.

As time went by, I met other people who were taking psychiatric medications. Most of them belonged to my alcoholism support group. It's strange: usually we're very quiet, but we always find one another; a slip of the tongue or a certain mannerism can be a tip-off. Talking to kindred spirits was a liberating experience that improved my self-esteem. The shame began to dissolve.

Many people who take medication live in fear of discovery. Self-disclosure is unthinkable ("I'll lose my job"). So a significant part of their lives remains hidden. That can lead to loneliness, the kind of isolation that was almost deadly for me. My recovery came only with my willingness to open up to others.

When the phrase "mentally ill" is used, pictures of the great unwashed, society's rejects, come to mind. Left untreated, I could quickly become one of these rejects if I lived long enough to reach the streets. But I am lucky. When the psychic pain brought me to my knees, I had a well-paying job and partial coverage under my employer's health insurance. It angers me that coverage for mental-health problems is substantially less generous than for other potentially fatal diseases.

My mental-health care has been expensive. I do not drive a new sports car or own a home. But my life is substantially better than it was before. I still have a job and I have friends. It has been a rough ride, but worth it.

My "marginal" friends, those who are not employed or who have part-time jobs, are not that different from me. Most of them are intelligent human beings who want to work and to develop a life that consists of more than finding enough money to buy the groceries. The main reason they cannot achieve their objectives is that good mental-health care is not available to them. These friends are not comfortable with being part of the welfare system; they want to be productive. Yet the overextended public mental-health-care system cannot provide them with the necessary care. If they are among the fortunate, they visit their psychiatrists every three months for 15 minutes. Many can't get therapy because therapists are not available. They do not receive the care that has enabled me to work and to develop a productive life.

The community as a whole helps perpetuate the stigma of mental illness. My friends remain society's rejects because they can't get help. In turn, mainstream society views the mentally ill with damning disdain. Given this vicious cycle, I am proud to say, "I'm mentally ill." I hope it gives a few people second thoughts about those "crazies" on the streets. If I lose my job, one of those people on the streets could be me.