This is a revised version of a previously published essay.
There is a huge stigma on mental illness and on mental health professionals in much of the western world, which gets in the way of honest discourse and helping people who are suffering from mental disorders. There is the attitude that psychology is an attempt to justify, rather than understand, and that mental disorders are a sign of an underlying character flaw, as opposed to a disorder or disease.
As Darryl Cunningham indicates: If someone gets diagnosed with cancer, their friends and family rally around them to support them. If they get diagnosed with paranoid schizophrenia, they tend to lose those support networks just as they are starting to need them most.
In the military you can get passed up for promotion or lose your security clearance if you get diagnosed with a mental illness. Doctors are also pressured by the military not to diagnose PTSD. Many mental illnesses are treated as something you just have to “man up” about, “get over,” or are treated as “not real illnesses.” Recently the JAG Tom Kenniff called vicarious traumatization psychobabble.
You can tell your friends you are going to the doctor to get treated for heart disease, or in most crowds a chiropractor for back pain. The response is dramatically different if you tell them you are going for treatment of your bipolar disorder, let alone paranoid schizophrenia or narcissistic personality disorder. There are taboos around these things, and these taboos make it significantly more difficult to get treatment.
This is further not helped by certain individuals, even (especially?) doctors who should know better, seeming to classify everything and the kitchen sink as being treatable exclusively or predominantly with chemicals, many of which have ugly side effects (including things like anterograde amnesia, a side effect of some of the anti-anxiety medications). Many others who seem to be of the opinion that everything is actually depression, even if it is, in fact, fibromyalgia or a thyroid condition.
Then we get into problems that therapists themselves run into thanks to malpractice, professional codes, and legal systems. Where we can look in retrospect and say “they misdiagnosed/misevaluated” or any number of other statements, but therapists who evaluate the situation will also say “There, but for the grace of God, go I.” Treating real humans is enormously complex, and the legal framework surround it is almost as complex. The situation puts tremendous strain on therapists, who may find themselves in a position of being unable to predict the future, and then being blamed for not being able to at a later point.
So what we get is a situation where a lot of people in this country have undiagnosed PTSD, major depression, anxiety disorders, paranoid schizophrenia, and a thousand other things. At a minimum, these impact their quality of life and some of them may get more serious without treatment (or, depending on the nature of the treatment, with treatment). They are unable (quite possibly because of insurance) or unwilling–possibly quite rationally so, depending on their situation–to visit mental health professionals and get an actual diagnosis. If they have dissociative identity disorder they may have amnesia blanks over periods of time where they self-sabotage, and they may have a fight with a lover only to not remember even having a conversation with them later. They may spend years blaming themselves or burning out, may try self-help which may or may not make the situation better (or worse), and spend a lot of energy hiding these illnesses and differences from others.
These things are so heavily stigmatized in our society, that the stigmas themselves make it more difficult to function independent of that the disorder itself makes it more difficult to function. This can and does make the situation significantly worse. This is something to pay attention to, because it isn’t something you can prevent by pretending it is “all in your head”: it really could be you or a loved one who starts to suffer in silence, do poorly in relationships at school, or their job, and feel there is no way out as a result.
Anything in Darryl Cunningham’s Psychiatric Tales, but especially the one on schizophrenia (also linked above) and this one on mental disorders in general.
Mental health: Overcoming the stigma of mental illness from the Mayo Clinic
National Association of Mental Disorders