mental illness

Stigma and the Choice to Disclose Your Mental Illness

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Maia Delegal

Feminist, violinist, mental health advocate, student, dog-lover, vegetarian, idealist.

Mental illness, though it is largely an issue of biological and environmental factors interacting to enforce certain maladaptive behaviors, is misunderstood. It is a common misconception that illnesses such as schizophrenia, bipolar disorder, and borderline personality disorder cannot be managed. However, there are millions of people around the world living and working as valued members of society who also happen to have these supposedly “scary” diagnoses. Mental illness gets a bad rap.

Mental Illness Stigma is super simple. It just means that most people don’t want to talk about mental illness openly or, if they do, they only want to talk about it in the abstract. People tend to want to distance themselves from the idea of mental illness.

People ignore mental illness because, in their eyes, mentally ill people are all outcasts, people with whom they would never choose to associate. Denial is a mechanism of convenience. By keeping things “hush hush,” no one has to apply their assumptions about people with mental illness to people they respect such as family or friends.

Recently, my friend went to our university’s counseling services for a diagnosis. He was seeking some sort of validation that he’s, in fact, dealing with something real. His mental health struggles get in the way of his day-to-day life, including his academic performance. Our disability resource center allows accommodations to help manage mental illness, given the right documentation to support its existence. So when he told me that his counselor refused to put his diagnoses on paper, I was appalled. Apparently, the counselor didn’t want to leave a “paper trail” of his mental illness, despite its potential to really help him cope. The counselor said they didn’t want the stigma of a diagnosis to follow him throughout his life, even though no one would know the diagnosis aside from other health professionals due to HIPAA/confidentiality rules.

Of course, the illness already affects his everyday life. From his struggle to make friends and connect with others, to his incapacity to keep up with certain school-related stressors and a lot of self-loathing, he routinely expresses feelings of isolation. I can’t speak for him, but something tells me a diagnosis would be more of a relief than a burden in his situation.

I know this friend from my work with my school’s chapter of the National Alliance on Mental Illness (NAMI). He joined in order to find support. Through the meetings, he’s found a commonality among the people who share their stories. It’s helped him branch out and feel safe. It often helps for people to join a community when they’re struggling with illness –of any kind. It’s possible a diagnosis would have helped confirm his sense of belonging.

But that’s how persistent this stigma is. Health records kept for the purpose of outlining accommodations are usually kept confidential, just like learning disabilities such as dyslexia. Yet, our culture is so frightened by the idea of mental illness that we deny its existence, causing even more difficulty. A diagnosis isn’t everything, but it can open up opportunities to connect with a community of people struggling with similar issues, learn about treatment options (including medicine), and understand how to best view one’s situation.

Disclosure is a personal decision. Many choose not to disclose health issues to their employers, peers, or even family members if they’re afraid of how it will alter their treatment. And that’s perfectly valid given the prevalence of stigma in this country. However, mental illness disclosure is often cited as an important step toward recovery. It can often be empowering for people to open up about their mental illness and then move forward with everyone’s understanding that their mental illness doesn’t define them or their abilities.