Can’t you just stop?
Americans are more likely to have a mental health challenge than they are to skip breakfast. Census data indicates a third of Americans now show signs of clinical anxiety or depression, while 1 out of 5 employees have a diagnosable mental health condition.
Offering widely accessible treatment is necessary, but not sufficient. Mental health challenges are neither created nor healed in a vacuum. They occur in the context of culture. Cultural change is up to all of us.
Though we’ve made a lot of progress, as a society we continue to push away mental health issues in a way that we don’t do with issues related to physical health. If someone tells their manager they are taking the week off because they have the flu, a compassionate manager might say, “Oh no, rest up, lot’s of fluids, feel better!” If someone tells their manager they are taking the week off because they have depression, even a compassionate manager might find themselves at a loss for words. Common responses I’ve heard include: “No prob. Just count it as vacation time.”; “Woah, I had no idea.”; and “…” (complete silence).
A 2019 study lead by Patrick Robinson and Daniel Turk at King’s College analyzed over 1 million tweets to assess how people talk about common health conditions (mental and physical). They found that mental health conditions remain significantly more stigmatized than physical health conditions.
This delta between how we treat mental health conditions versus how we treat physical health conditions perpetuates stigma. Though the term stigma can feel amorphous, the barriers created by stigma are tangible. Due to stigma, employers may be less likely to offer comprehensive mental health services. Employees may be less likely to use services, for fear of repercussions if their employer finds out. A 2020 study from the Journal of Mental Health found internalized stigma can reduce someone’s sense that they need treatment, reduce their expectation that treatment can be helpful, and even reduce their recognition of existing resources.
But here’s the silver lining in the fight against stigma: Because stigma is built and perpetuated by all of us through everyday actions, we can all play a part in dismantling it. Dismantling stigma, and improving the situation is within our control, at least in part.
One place to start is by becoming aware of two common stigma-enhancing behaviors:
(1) Trivialization – Trivialization refers to the habit of minimizing a mental health condition. Research suggests it happens when terms are adapted into common parlance, without a clear understanding of the meaning. According to the aforementioned study by Robinson & Turk (2020), OCD is the most trivialized condition. A common example is someone saying, “I’m so OCD” when referring to their preference to have their items neatly arranged, without regard for the amount of suffering associated with Obsessive Compulsive Disorder.
Going back to the example of someone telling their manager they are taking the week off due to depression, a trivializing response would be: “Oh yeah, I’ve been sad too lately.” “No prob. Just count it as vacation time,” would also be a trivializing response for it doesn’t acknowledge depression as worthy of sick leave, and it seems to suggest dealing with depression could feel like a respite.
(2) Promoting the myth of controllability – Another stigma inducing behavior is language that promotes the myth that mental health challenges can be controlled through willpower alone. This myth is particular common with depression (“Just get out of bed and start your day, and you’ll feel better!”) and eating disorders (“Just eat!”). A manager might support this myth by saying something like, “I know you need a week off for mental health, but can you take it next month instead.” This statement assumes mental health challenges can be turned on or off at will like a light switch.
Do you recognize either of these behaviors in yourself or in those around you? If so, simply bringing awareness to them is an important precursor for change. From awareness comes an opportunity to make the choice to do it differently.
Very often the perpetuation of stigma lives inside the nuances of what we say and how we say it. Though there’s so much more to reducing stigma than shifting these two common behaviors, they are meaningful in that they get us looking closely to the person we can best control: ourselves.