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Stigma of Bipolar Disorder

There are few things in the world that are as stigmatizing as bipolar disorder.

Some stigma, by definition a mark of shame or disgrace, has been debunked and exposed as ignorance and superstition; some others fly in the face of medical evidence and are widely accepted as the gospel truth.

Popular terms – words like “psycho” and “loony bins” – have been with us for a long time; the word bedlam is derived from the famous Bethlem Royal Hospital in London, the world’s first and oldest institution to treat the mentally ill (although I use the word “treat” lightly.) In recent years popular stigma of mental health disorders have lessened somewhat by a spate of books on the subject. The oldest I could find was Paul Jay Fink’s and Allan Tasman’s “Stigma and Mental Illness,” published in 1992; one of the latest was “The Mark of Shame: Stigma of Mental Illness and an Agenda Change” by Stephen Hinshaw, chair of UC Berkeley’s Department of Psychology, published in 2007. Quite a few of the errors dealth with Fink and Tasman were still prevalent when Mr. Hinshaw wrote his book fifteen years later. For example, both books mention that media portrayals of the mentally ill as violent and dangerous are as popular as ever.

I have no desire to add to the pantry of popular-stigma out there, but you may be interested in a brief compilation of the misconceptions I ran across myself. I’ll set them down here in a style I usually disdain:

1. That the term “bipolar disorder” means it is not as real as a physical illness, such as cancer or heart disease. (Wrong.)

2. That the word “mental” implies it is really just a figment of their imagination and a result of their own bad choices and actions. (Also wrong.)

3. That a mental health disorder means a person is just lazy and unmotivated, lacking stick-to-it-iveness. (In many cases, the mentally ill person will start to believe this and it becomes a self-fulfilling prophecy.)

4. That’s it is “all in their head.”

5. That they are more prone to violence and criminal behavior. (Statistics just don’t support this; most people who are mentally ill are neither violent or criminal.)

6. That they are somehow themselves to blame, it’s their own fault, and they just need to “get over it.”

7. That, while no one would think of mocking someone with, say, leukemia, it is perfectly all right and even natural to poke fun at the so-called “illness” of one with bipolar disorder.

8. That they are somehow morally “inferior” to the rest of us.

9. That, because they can put their pants on one leg at a time like the rest of us, they do not fit the classic definition of having a “disability.” (Untrue; in fact, medical evidence has shown there is no more reason to deny the objective reality of mental illnesses than the objective reality of physical diseases.)

I rather expect that some or all of these widespread stigma are locked away somewhere in your own mental framework; you’d be in the minority if they weren’t. Mostly everyone believes one or more of these things. What’s more: stigma is popular because everyone loves a good joke, a comic foil.

Why is stigma so popular? Even my brief list shows we stick to our opinions rather than sacrifice some our habits of thought. To do that is the hardest thing of all. “No wonder,” E.F. Torrey once wrote, “Eugene O’Neill in ‘Strange Interlude’ had the family hide their mentally ill aunt in the attic.”

Not long ago, a team of graduate psychology students studied the thinking of grade schoolers and their parents in Berkeley, California, to find out how they responded to film clips about mental illness. The team also found that a clinical psychology class on the same campus became extremely uncomfortable when one of their own unexpectedly revealed that she suffered from bipolar disorder. Faced with the disorder up close and personal, the students were no longer as “engaged and excited” as they had been when learning about mental illnesses from a distance. Of course, they prided themselves on having an open mind on issues of race, ethnicity, and gender. The same empathy, however, was not afforded to the student from her classmates, who, according to Andrea Stier, a grad student at UC Berkeley, “refused to make eye contact with her, and were quiet and withdrawn.” If anything, they were judgmental, within. “Recognition has not been given to prejudice,” Berkeley psychology professor Rodolfo Mendoza-Denton concluded, “or its consequences, based on mental illness.”

Meanwhile, in spite of all this hostility, researchers persist in the study of public versus hidden attitudes about mental health disorders. There is a serious approach going on of the depiction of the mentally ill in the media, the historical ignorance regarding these disorders, and the study of the complex biological and genetic causes of these things. Just to be clear, I’m referring in this article to well-known but misunderstood disorders such as schizophrenia and bipolar disorder, formerly known as manic depression. These researchers are on the front lines of getting Congress to take this issue more seriously and enact laws that are as fair to the mentally disabled as they are to the physically disabled.

In the meantime, however, our basic prejudices, our basic ideas, will continue to keep untold thousands, perhaps millions, from stepping into the light of day and get the treatment that is available in many cities. For all the gains we’ve made in understanding mental health, that indispensible quality needed for all of our mentally ill-empathy-remains an elusive goal.

(Some info on this article was partly obtained by Yasmin Anwar’s article – “Stigma of mental illness explored” – at berkeley.edu/news/media/releases/2007/01/16_stigma.shtml)