By Cassie Jewell, LPC, LSATP
In this post, I’ll address some of the myths and misconceptions about mental disorders. There continues to be stigma attached to mental illness; and the media is partly to blame. Every time (yet another) mass shooting occurs, the media attributes the act of violence to mental illness. This message is repeated by various news sources and then spread through social media.
Acts of senseless violence are for sure a “sickness,” but they’re not criteria for a diagnosable mental disorder. It’s not fair to compare violent criminals to individuals who struggle with depression, anxiety, schizophrenia, etc.
Mental illness misconceptions run rampant, even within the healthcare professional field. For example, I know a surgeon who believes mental illness isn’t real and a neurologist who uses words like “crazy” and “retarded.” I came across a substance abuse counselor (on Facebook) who believes addiction is a moral failing. I know a social worker who believes that severely mentally ill individuals are more likely to be violent.
Ignorance is at the root of stigma. The more you know, the less you fear, and the less you’ll stigmatize. Read on to learn what’s myth versus fact.
1. Bad parenting causes mental illness.
Even today, there is no single identified cause when it comes to mental illness. Instead, there are multiple risk factors that contribute to mental disorders. The biggest risk factor is genetics. Genes frequently determine whether or not a person develops schizophrenia, depression, substance use disorder, etc. Physiological factors (such as abnormalities in the brain) are a second risk factor.
Environmental factors, such as fetal exposure to a toxin or childhood abuse, are a third risk factor. Childhood abuse undoubtedly falls into the “bad parenting” category, but as a standalone, it can’t cause mental illness.
It’s more likely that a combination of risk factors will lead to the development of a mental disorder.
2. Mental illness is not a medical disease.
Heart disease affects the heart. Colon cancer affects the colon. Autoimmune disorders affect the immune system. Brain disorders (i.e. mental illness, addiction) affect the brain.
You can’t “see” mental health symptoms the way you can see physical health symptoms, but mental illness is without a doubt physiological in nature.
Like other organs, the brain can become diseased, and it manifests as symptoms of mental illness. You can’t “see” mental health symptoms the way you can see physical health symptoms, but mental illness is without a doubt physiological in nature.
3. All sociopaths are dangerous.
The term “sociopath” (or psychopath) is frequently associated with serial killers. The reality is that you probably know a sociopath and he/she isn’t a murderer.
In fact, “sociopathy” and “psychopathy” are no longer recognized diagnoses in the mental health world due to negative connotations. The correct term is “antisocial personality disorder” (ASPD), a mental illness characterized by an ongoing disregard for and violation of the rights of others. An individual with ASPD may also be exceptionally charismatic. (Some of the most charming and engaging clients I’ve ever worked with had ASPD.)
However, research indicates that an individual with ASPD is more likely to become involved in criminal activity,to have a substance use disorder, and to be aggressive; about 50% of individuals with ASPD have some sort of criminal record. While it’s a misconception to say all individuals with ASPD are dangerous, the link between ASPD and crime is not unfounded.
4. Mental illness can be overcome with willpower.
This is 100% myth and a huge pet peeve of mine. It goes hand-in-hand with the belief that mental illness is not a “real” medical condition. A mental disorder typically requires treatment, such as medication and therapy, and ongoing illness management.
All the willpower in the world won’t help someone “overcome” heart disease. And it doesn’t work that way with mental illness either.
5. Addiction is a choice.
Substance use disorder is no more of a choice than diabetes or cancer. Like most diseases, addiction develops when a combination of genetic, physiological, and environmental factors are present. Lifestyle choices also play a role. Unfortunately, the myth that addiction is a moral failing persists.
An individual who struggles with addiction receives more blame than someone with a heart condition, even though lifestyle choices heavily impact both disorders. I’ve even heard it said that addicts who overdose shouldn’t be revived because it was their “choice” to use. If that’s the logic, then should we stop providing life saving care to someone who’s having a heart attack or to a smoker with lung cancer? Of course not. At times, we all make poor decisions. For someone with a predisposition for addiction, the choice to drink may lead to alcohol use disorder. For the person with a predisposition for diabetes, eating an unhealthy diet or living a sedentary lifestyle will result in consequences.
Furthermore, once a person develops a substance use disorder, physiological and structural changes in the brain dissolve the element of choice. The brain misinterprets a craving for drugs or alcohol. (Remember the last time you experienced extreme thirst? That’s what it’s like to be addicted to something.)
Having a substance use disorder is miserable, lonely, and shameful. No one would choose that.
6. People with mental illness are violent.
A person with mental illness is no more likely to be violent than someone in the general population. In fact, acts of violence are not diagnostic criteria for any of the known mental disorders.
If I had to choose someone to hold a loaded gun, I’d pick the person with schizophrenia over someone who’s prone to anger or has poor self-control.
I work with clients who hear “command” voices (auditory hallucinations that tell them to harm or kill); yet I’ve never felt unsafe. In my experience, it’s uncommon for an individual to obey the voices. If I had to choose someone to hold a loaded gun, I’d pick the person with schizophrenia over someone who’s prone to anger or has poor self-control.
While the media would have us believe that mental illness is at the root of every mass shooting, that isn’t the case. (Not to say that mental illness can’t play a role, but it’s not always the trigger.) The biggest risk factor for violence is a history of violence, especially domestic violence, or crime.
Regarding violence, what’s true is that individuals with mental illness are more likely to die by suicide. Persons with schizophrenia have higher rates of suicide than the general population. Depression, bipolar disorder, and borderline personality disorder are also linked to suicide.
Don’t confuse mental illness with a lack of morals.
A mental disorder is a medical condition; having weak morals is a personality trait, and while it seems mentally sick, it’s not fair to compare a lack of morals to a condition like depression or anxiety.
7. Mental illness is the same thing as mental retardation.
I’m friends with a nurse who didn’t even know the difference (until I pointed it out). A person with a mental illness may seem less intelligent due to various factors, but mental illness is not comparable to mental retardation. Today, we refer to mental retardation as intellectual disability (due to the negative connotations attached to the word “retarded”).
A person with an intellectual disability (ID) struggles to understand, comprehend, and/or form memories. A person with mental illness, on the other hand, may have superior intelligence, but could seem “slow” due to distractions brought on by their illness. (For example, it’s difficult to focus on a conversation when you’re having racing thoughts or hearing voices.)
8. A person with schizophrenia has multiple personalities.
Nope; total myth. In fact, multiple personality disorder (MPD) doesn’t exist (technically). What was formally known as MPD in the DSM-IV TR (the previous version of the Diagnostic and Statistical Manual) is now termed disassociative identity disorder [DID]. A person with DID has at least two distinct personality “states” and suffers from gaps in memory. DID is incredibly rare.
A person with schizophrenia, on the other hand, has one personality state. However, he/she may hear voices that take on distinct identities.
In addition to auditory hallucinations, someone with schizophrenia may experience visual hallucinations, delusions, disorganized thoughts, cognitive deficits, and/or what’s referred to as “negative” symptoms. (A negative symptom is a lack of something that’s typically present in someone without schizophrenia. For example, a person with schizophrenia may be socially withdrawn or he/she may seem very “flat” [without emotion]).
9. Alcohol makes you depressed because it’s a depressant.
Yes, alcohol is a depressant; but as a “depressant,” it depresses your central nervous system, leading to slurred speech, trouble with coordination, etc. The “depressant” effects of alcohol are unrelated to clinical depression.
However, heavy alcohol use is associated with depression and other mental disorders. Someone who is struggling with depression or anxiety may drink as a way to self-medicate. Alternatively, someone with an alcohol use disorder may develop depression, as alcohol upsets the chemical balance in the brain. The lifestyle of someone with alcohol use disorder may also lead to intense guilt, shame, and/or hopelessness, which can in turn lead to depression.
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