15 Common Misconceptions About Addiction

Misconceptions about addiction are prevalent in today’s society and contribute to stigma. This is a list of 15 common misconceptions about addiction.

Despite a large body of scientific research, myths and misconceptions about addiction remain prevalent in today’s society, contributing to stigma, barriers to treatment, and higher health burdens. The following is a list of common misconceptions.


15 COMMON MISCONCEPTIONS ABOUT ADDICTION

1. Misconception: Addiction is choice.

Fact: Addiction is widely recognized as a primary disorder of the brain. According to the American Society of Addiction Medicine, “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” Heavy and continuous use of drugs/alcohol damages the brain, increasing the likelihood of addiction.

Despite this, choice can play a role in long-term sobriety, similar to how lifestyle decisions (i.e. treating symptoms, exercising, eating well, etc.) play a role in the management of other chronic illnesses such as diabetes or heart disease.

2. Misconception: Addiction is a character flaw or weakness.

Fact: The idea that addiction is a moral failing is based on the moral model of addiction. The reality is that addiction has little to do with moral conviction; both inherently “good” and “bad” people are susceptible to developing a substance use disorder.

That being said, a person in active addiction may act in contrast to their values; but that doesn’t mean they’re morally flawed. The moralization of addiction and associated stigma only contribute to guilt, shame, and a decreased willingness to seek treatment.

3. Misconception: Addiction is the result of a lack of willpower (and if someone “wanted it enough,” they would quit).

Fact: Like other chronic illnesses, addiction cannot be “willed” away. Individuals with substance use disorders are not compromised in willpower or lacking in self-discipline.

“The mentality and behavior of drug addicts and alcoholics [are] wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help, they have no hope.”

Russell Brand

4. Misconception: Some people have “addictive personalities.”

Fact: The truth is that every personality “type” is prone to addiction; we’re all biologically wired for addiction since our thoughts/behaviors are influenced by the brain’s reward system. Risk factors, not personality traits, are linked to the development of a substance use disorders. Risk factors may include biological influences (including genetics and differences in brain receptors), environmental influences, age of first use, and method of use.

5. Misconception: Many people use trauma as an “excuse” for using drugs/alcohol.

Fact: There is a strong association between trauma and addiction, and research indicates that addiction is directly linked to childhood abuse and trauma. It may seem like an excuse, but substance use is oftentimes a means of survival and/or a way to cope with unthinkable atrocities.

6. Misconception: Relapse is part of the process.

Fact: While relapse is relatively common, it doesn’t have to be a part of recovery. There are many contributing factors, both biological and environmental (i.e. stressors), that increase the chances of relapse.

Successful relapse prevention plans involve the avoidance and/or management of risk factors. Also, the less severe the addiction, the more likely someone is to avoid relapse altogether.

7. Misconception: Abstinence is the only path to recovery.

Fact: Recovery is not one-size-fits-all. For some, abstinence may be the only acceptable route, but for others, a reduction in use or the use of a less harmful substance is the desired outcome.

8. Misconception: You have to attend 12-step meetings and work the steps to get sober.

Fact: While AA and NA are often part of sustained sobriety, they are not the only way to stop using drugs or alcohol. Alternative evidence-based treatments for addiction include cognitive behavioral therapy, medication, family therapy, and group therapy.

9. Misconception: You have to be “ready” to stop using in order for treatment to work.

Fact: Addiction is characterized by ambivalence (i.e. you want to get sober and at the same time, you want to get high). Motivation comes and goes. A person may enter treatment with no intention of quitting, and then undergo a significant transformation. Or, someone may feel 100% ready to stop only to later change their mind. Ambivalence is normal.

That being said, the consequences of addiction (or costs of using) are oftentimes what tip the motivational balance, leading to increased motivation.

“When you can stop, you don’t want to, and when you want to stop, you can’t.”

Luke Davies

10. Misconception: You have to want recovery for yourself before you can get sober.

Fact: External motivators (i.e. the threat of losing a job, divorce, legal consequences, etc.) frequently precipitate treatment, and motivation is then internalized during treatment.

Research indicates that success rates of mandated treatment are similar to voluntary treatment; moreover, mandatory treatment is associated with increased rates of completion.

11. Misconception: You have to hit “rock bottom” before you can recover.

Fact: Sustained sobriety can be attained without experiencing severe consequences. While the costs of using are often what motivates someone to get sober, there’s no rule that you have to “bottom out” first. This misconception can be deadly; you may die waiting (or death may be your “rock bottom”).

“Remember that just because you hit bottom doesn’t mean you have to stay there.”

Robert Downey, Jr.

12. Misconception: If you’re receiving medication-assisted treatment (MAT), you aren’t really sober.

Fact: MAT is a highly effective evidence-based treatment for opioid use disorder; it helps to sustain long-term recovery. There are also FDA-approved medications for the treatment of alcoholism. MATs effectively and safely relieve withdrawal symptoms and reduce psychological cravings.

13. Misconception: Needle exchange programs and safe injection sites enable continued use.

Fact: Harm reduction methods reduce HIV/HCV infections and decrease overdose deaths. According the the CDC, “the majority of syringe services programs (SSPs) offer referrals to medication-assisted treatment,  and new users of SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.” SSPs are proven and effective, and aren’t linked to increased drug use or crime.

14. Misconception: Narcan enables continued use.

Fact: Narcan (an opioid reversal medication) enables life. It gives someone a chance for recovery.

15. Misconception: “Once an addict, always an addict.”

Fact: Having a substance use disorder increases your chances of becoming addicted to other substances, but the belief that you’ll forever be an “addict” can be counterproductive or harmful. People grow and change, and may stop viewing themselves as “addicts” when they leave the lifestyle behind.

The belief that “once an addict, always an addict” also depends on the recovery model you subscribe to; for example, AA/NA principles support the idea of the “lifelong addict,” but those who believe in other models may prefer to call themselves “ex-addicts” or simply say, “I don’t drink.”

“Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending.”

Carl Bard

misconceptions about addiction

Interview: Substance Abuse Counseling

An interview with JS, a substance abuse counselor who works with people from all walks of life.

JS is a certified substance abuse counselor who works at a residential treatment center in northern Virginia. The following article is about his work, thoughts on relapse, what it’s like to lose a client, stigma, and valuable advice for anyone considering a career in addiction counseling.


Interview: “They Are Just People”

JS works at an intermediate-length residential center for adults with substance use and mental health disorders. The clients live in shared dorms and adhere to a daily schedule that includes counseling, psychoeducation, groups, 12-step meetings, and medication therapy.

Once a client successfully completes the inpatient portion of treatment, they transition to “re-entry.” In re-entry, clients reside in sober living homes and receive continuing care services. They are able to look for employment, start working, and “re-enter” the larger community. JS provides counseling and support services for this component.

Inspired to help

JS has personal experience with addiction. “I am a person in recovery… About a decade ago I found myself in a very dark place and had to get help… I met a substance abuse counselor [who] changed my life. He educated me, engaged me, and challenged me. He was instrumental in turning my life around.”

With his counselor’s encouragement and support, JS made the decision to get back on track. He realized that he wanted to help others who struggled. “My own experiences with addiction allow me to have an incredibly deep empathy for the clients I serve and the fulfillment I receive in return is unreal.”

“Addiction does not discriminate”

JS works with people from all walks of life. He’s worked with individuals who are homeless to young fathers to successful businessmen; from people in their teens to adults in their late 80’s. “There is no age, sex, gender, race, sexual orientation, religion, occupation, or economic class that is safe from addiction.”

As for the substances abused, the list is never ending, but JS regularly sees people addicted to alcohol, opiates (including heroin), cocaine, methamphetamine, and PCP. Many of the clients he counsels also have mental illness such as depression, anxiety, or bipolar disorder.

No typical days

According to JS, “typical” days don’t exist where he works. “There is no way to describe a typical day in this field. One day I could be [providing therapy] and another day could involve a trip to the emergency room or helping out with chores… I never know what to expect and I never get bored.”

Effective treatment planning is important for substance abuse counselors; JS meets with his clients to develop an individualized service plan. Clients come up with their own goals, and JS supplies interventions to help them achieve their goals over the next couple of months.

According to JS, client goals vary, ranging from attending 12-meetings to obtaining a driver’s license to enrolling in school; basically, a goal can be any life skill a person may need for success. Corresponding interventions could include providing bus tokens to get to AA meetings, linking to driving school, and helping to fill out college applications and apply for financial aid.

JS explained that adults who have been incarcerated or dealing drugs for a living miss out on major milestones such as learning to drive, attending college, renting an apartment, etc. Furthermore, basic skills that many of us take for granted, such as filling out an online form or depositing a check can be overwhelming for someone newly in recovery who never learned how.

JS meets with his clients at least once per week for therapy sessions. I asked what comes up in a typical session and his response was “anything and everything.” Sessions may involve reviewing goals, learning coping skills, poop jokes (his clients are all men), or processing childhood trauma.

Substance abuse and relapse

“Not good” was JS’s response when I asked what the success rate was for someone who completes re-entry. He explained that this is a reflection of the general rates of recovery in substance abuse, which are low. “It can be disheartening, working with someone for months and when they leave, they relapse in less than a week.”

JS explained that while relapse is a deterrent to the field for some counselors, he sees it differently. “For me, it will never be a deterrent. My battle with addiction was not easy, nor was it accomplished in a single attempt. Relapse is a part of my story. I would not be here if people gave up or lost hope that I could get better. For that, I will never give up or lose hope that my clients can recover, no matter how many times they relapse.”

For JS, losing a client, not relapse, is the hardest part of the job. “I’ve worked with many clients who didn’t make it. I’ve lost clients to overdose, suicide, and homicide. It never gets easier.”

JS grieves for his lost clients. “I find myself wading through the stages of grief until I reach some level of acceptance.”

What everyone needs to know about substance abuse

“The people I work with are just people. They are your sister, your cousin, your neighbor, or the guy in line at the grocery store. They are people with families, jobs, hobbies, and dreams.”

JS discussed ignorance and stigma; he shared that individuals with substance use disorders are often subjected to mistreatment, even from professionals in the field. “There are substance abuse counselors who perpetuate harmful addiction myths, once widely accepted as fact, but discredited by the scientific community decades ago.”

JS shared examples of common myths:

  • “All addicts are liars.”
  • “Addicts are lazy and selfish.”
  • “It’s not a disease, it’s a choice.”

“The lack of compassion when it comes to substance abuse is mindboggling and painful to encounter. Often, it stems from a lack of understanding or knowledge about substance abuse and those with substance use disorders. They are just people who are struggling with something far beyond their control. And those in treatment? They are just people trying to get better. And in case I didn’t make it clear; they are just people.”

Advice for new substance abuse counselors

“Be willing to learn. The field of addiction treatment is constantly changing. Standard practices from 20 years ago are now ineffective and outdated. If you want to do this work, be open to learning the newest treatment models, medications, and research on addiction. This field is not static, and we do our clients a major disservice when we quit learning.”

As a last piece of advice, JS suggested self-care for substance abuse counselors as a way to combat burnout. “Identify ways to decompress. This job is not easy. Some of the people you help will die. Compassion fatigue is a real thing and you must take care of yourself to care for others.”


“They are just people.”

JS

substance abuse

40 Worst Comments About Mental Illness on Quora

What questions are people asking about mental health? Quora posts indicate that misconceptions and myths related to mental illness and addiction prevail. Read the top 40 most unsettling questions on Quora.com.

I turned to Quora (an online platform for asking questions) to see what people today are asking about mental illness. What I found ranged from thought-provoking to comical to disturbing, illustrating how common misconceptions are. Here are some of the worst comments and questions I came across:

woman sleeping
Photo by Ivan Oboleninov on Pexels.com

40 Worst Comments & Disturbing Posts About Mental Illness (on Quora)

1. “Is mental illness really an illness?”

2. “Is mental illness catchable?”

3. “Do people with mental disorders have friends?”

4. “Are people who self-harm just looking for attention?”

5. “Is drug addiction really just a lack of willpower?”

6. “Can a person be intelligent and a drug addict?”

7. “Should drug addicts be left to die?”

8. “Why can’t drug addicts just stop? What compels a person to continue with a destructive behavior despite the obvious problems their behavior causes?” (Note: Addiction is a brain disease, which is why someone struggling with substance abuse can’t “just stop.”)

9. “Why should one feel sorry or sympathetic for drug addicts, given most of them chose this life?”

10. “Instead of ‘rescuing’ drug addicts who have overdosed, wouldn’t society as a whole benefit from just letting nature take its course?” (If that was the case, shouldn’t we then withhold all types of medical treatment and preventative or life-saving measures… to allow nature to take its course?)

11. “Is there any country in the world that won in the war against drugs by killing the users or the drug addicts?”

12. “Why should we lament drug addicted celebrities dying of drug-related causes? It’s their fault for starting a drug habit.”

13. “Why save drug addicts from overdosing? From my experience they were problems for their families, a drain on society from their teen years, and won’t get better once addicted.” (All diseases are a drain on society to an extent; that doesn’t mean lives aren’t worth saving.)

14. “How do you differentiate between drug addicts and real homeless people when giving money?” (You don’t; find other ways to help.)

15. “What are the best ways to punish an alcoholic?”

16. “Don’t you think it’s time we stop spreading the myth that alcoholism is a disease? You can’t catch it from anyone. One chooses to drink alcohol.”

17. “Why do people who are oppressed/abused never defend themselves and have pride?”

18. “Why don’t I have empathy for people who end up in abusive or unhealthy relationships? I feel that they deserve it for being such a poor judge of character.”

19. “Why do most women put up with domestic violence?” (Most women?? “Put up”??)

20. “Are schizophrenics aware they’re crazy?”

21. “Are schizophrenic people allowed to drive?”

22. “Do people who become schizophrenic become that way because they are morally conflicted?”

23. “Are schizophrenics able to learn?”

24. “Can a schizophrenic be coherent enough to answer a question like ‘What is life like with schizophrenia?’ on Quora?”

25. “Can one ‘catch’ schizophrenia by hanging out too long with schizophrenics?”

26. “Can schizophrenics have normal sex?” (Yes, or kinky, whichever they prefer)

27. “Why do people ignore the positive impact spanking has on raising children?” (See #28)

28. “Is being spoiled as a child a cause of mental illness such as depression?” (No, but spanking is linked to mental disorders and addiction in adulthood.)

29. “Should mentally ill people be allowed to reproduce?”

30. “Should people with mental illness be allowed to vote?”

31. “Are we breeding weakness into the gene pool by treating and allowing people with physical and mental illnesses to procreate?”

32. “Why are we allowing mental illnesses of sexual orientation disturbance and gender identity disorder that were changed for political reasons, to be accepted like race?”

33. “Why do some people with mental illness refuse to work and live off the government when they are perfectly capable of working?”

34. “Why are mentally disturbed women allowed to have children?”

35. “I feel no sympathy for the homeless because I feel like it is their own fault. Are there examples of seemingly “normal” and respectable people becoming homeless?”

36. “How is poverty not a choice? At what point does an individual stop blaming their parents/society/the government and take responsibility for their own life?” (White privilege at its finest)

37. “Why are mental disorders so common nowadays? Is it just an “excuse” to do bad or selfish things?”

38. “Are most ‘crazy’ people really just suffering from a low IQ?”

39. “Why do some people have sympathy for those who commit suicide? It is very cowardly and selfish to take your life.”

40. “Is suicide part of the world’s survival of the fittest theory?”


worst comments

Please leave your thoughts/feedback in a comment!

4 Ways to Fight Stigma with Language

Words have power. They are impactful. They can contribute to stigma and divide humanity. To help fight stigma, change your language.

Have you ever been called a bitch? A creep? A whore? Have you received criticism that felt unfair or dismissive? Maybe someone’s words made you feel belittled or unappreciated. Language has the power to shape our experiences, and words become weapons when used to wound.

Consider the power of hearing your name spoken aloud. It instantly grabs your attention, pulling you into the present moment. You’re most likely going to respond or at least pause in what you’re doing.

Words are impactful, not only for the person being labeled, but for an entire group of people. They contribute to stigma while fueling biases. They can divide humanity. Retard. White trash. Crazy. Junkie. N*****. Slut. Spic.

Why Language Matters: 4 Words/Phrases to Stop Saying

If you side against ignorance and want to end the stigma associated with mental illness, change your language. The following words or phrases contribute to stigma:

“Addict”

There are many negative connotations surrounding this word. Similarly, “alcoholic” can be demeaning. A person who is addicted to drugs or alcohol has a medical condition. Instead of calling them an addict (or junkie or tweaker or crackhead), say “person with a substance use disorder.” Demonstrate the same empathy you would for a person who has cancer or MS or paralysis.

“Schizophrenic”

Don’t label a person who suffers from mental illness. They are more than the disorder they’re afflicted with. Calling someone “schizophrenic” or “borderline” or “bipolar” reduces them to an illness, not a person. It’s dehumanizing.

“Retarded”

True, “mental retardation” used to be the diagnostic terminology for classifying individuals with lower IQs. Today, however, it’s mostly used as an insult. The American Psychiatric Association has eliminated the term as a classification; the correct term is “intellectual disability.”

“Committed suicide”

This phrase suggests that the person who dies by suicide is criminal. Criminals commit crimes. An individual who dies by suicide should not be placed in the same category. Instead, say “died by suicide.” This demonstrates respect for both the individual and their loved ones.


Language has the power to influence and shape the world. You have power. Be a positive influence and choose to fight stigma instead of contributing to the toxicity.


#JunkieLivesDontMatter

Many believe that addiction is choice and that individuals who use drugs are just “junkies” – and #JunkieLivesDontMatter.

This article is inspired, in part, by an ignorant (not ill-intended) meme posted by a healthcare worker on social media.

The meme said,

“So if a kid has an allergic reaction the parents have to pay a ridiculous price for an Epi pen. But a junkie who has OD’d for their 15th time gets Narcan for free? What a screwed up world we live in.”

Implication: A “junkie” doesn’t deserve a second chance at life. (#JunkieLivesDontMatter) They’re a waste of resources because they lack the willpower to stop using. A person with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more deserving lives.)

Image by Pexels from Pixabay

If you believe it is screwed up for a “junkie” to have a chance at life (and recovery) because they “chose addiction,” your opinion is contrary to the National Institute of Health, the American Medical Association, the American Psychiatric Association, and decades of scientific research. You’re also a part of the movement: #JunkieLivesDontMatter

Image by SplitShire from Pixabay

Many have joined the movement, as evidenced by the following social media posts:

“Out of all of the houses, 2 hobos decided to overdose on my front steps… thank god the medics got here in time to ensure they could die another day…”

“I think we had less ODs before Narcan came on board. They realize they can be saved if gotten to in time. Maybe they need to be locked up & not let out until they attend rehab while in jail.”

“If it can be easily established that they have a recent history of drug [abuse]… then yes… withhold the lifesaving drug because they chose this. It’s harsh, but justice is not served by saving them.”

“If you don’t have it figured [out] by the 3rd overdose, you are just prolonging the inevitable and wasting tax payers money.”

“If we are repeatedly saving your life and you are not willing to change this behavior, why should we be obligated to keep saving you?”

“My personal opinion is we can’t keep letting people overdose and saving them just so they can repeat the cycle.”

“By continuously administering Narcan, sure, we’re saving their life, but are they really living? I don’t think so.”

#JunkieLivesDontMatter

Image by Myriams-Fotos from Pixabay

#JunkieLivesDontMatter: Addiction & Stigma

According to the American Psychiatric Association,

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems.

Addiction is a scientifically-proven brain disease. Despite this, many persist in the belief that it’s a choice, or worse… a moral failing.

The notion comes from an early model of addiction, “the moral model,” which was deeply rooted in religion. Addiction was attributed to a sinful nature and weakness of character. Therefore, the addict must repent… or suffer the consequences of his/her actions; addiction warranted punishment, not empathy. Unsurprisingly, this created stigma. It also prevented those struggling with addiction from seeking treatment.

Centuries later, many hold on to the view that an individual suffering from a substance use disorder is lazy or weak… or a worthless junkie.

Today, in the midst of the opioid epidemic, stigma’s unrelenting grip perseveres. Stigma is a poison; it’s dehumanizing. It’s easy to forget a person is a person when you view them as garbage, trash… a “junkie.” Stigma tells us, “Take out the trash.” #JunkieLivesDontMatter

Image by Hamed Mehrnik from Pixabay

To fully recognize stigma’s impact, compare addiction to other diseases. Consider common medical emergencies; many are related to lifestyle. Imagine being hospitalized after your third stroke, and the doctor telling you, “This is the third time I’ve saved your life, yet you refuse to exercise. I shouldn’t be obligated to continue to provide life-saving care.” Or, imagine a long-time smoker who develops lung cancer; they’re not demeaned, called names, or denied treatment.

Moreover, an EMS worker wouldn’t withhold CPR from an individual in cardiac arrest if they were obese. It’s not a debate.

If You’re Dead, You Have a 0% Chance of Recovery

We’re in the midst of an epidemic.

According to the CDC, 115 Americans die from an opioid overdose every day.

In 2016, over 42,000 individuals died from opioid overdose.

Life expectancy in America is actually declining due to an increase in fatal overdoses.

Image by Simon Orlob from Pixabay

Narcan does not enable addiction. It enables life. (The dead can’t recover.)

#Recovery #Empathy #FightStigma #EndTheEpedemic #SaveALife


If you live in Fairfax County (Virginia), sign up for a free REVIVE! Training!

#junkielivesdontmatter

9 Dangerous Myths & Misconceptions About Mental Illness

Are mentally ill people violent? Can mental illness be overcome through willpower? Is addiction a choice? This post addresses some of the myths and misconceptions about mental illness.

There is stigma attached to mental illness and substance use. The media, unfortunately, perpetuate stigma by spreading misinformation.

For example, every time a school shooting occurs, the media attributes it to (or at least references) mental illness. Journalists first, and then social media trolls sensationalize news stories about the shooter’s eccentricities and all the signs that were missed. Upon learning that the shooter was having problems at home and didn’t get along with his peers, one might suspect mental illness. And suspicion becomes certainty when mental illness is viewed as the only plausible rationale behind the senseless violence. (It’s also rationalized that ‘normal’ people don’t shoot each other for no reason. So when there is no apparent motive, mental illness is blamed.)

Next, mainstream media circulates the story about the depressed kid turned killer. The message received is “mental illness is dangerous” or “people with mental disorders are criminals.” This misinformation is absorbed and regurgitated in society, online and off, and misconceptions about mental illness persevere.

Unfortunately, misconceptions about mental illness are common, and not just with the media. Even healthcare workers, including mental health professionals, believe common myths.

In this post, I will address some common myths and misconceptions about mental illness.



Ignorance is the root of stigma.
 The more you know, the less you fear, and the less you’ll stigmatize. Read on to learn about myth versus fact.


9 Myths & Misconceptions About Mental Illness

1. Bad parenting causes mental illness.

MOSTLY MYTH

Even today, there is no single identified cause that explains mental illness.

However, there are multiple known risk factors (biological, environmental, and social) that contribute to the development of mental disorders. Having a genetic predisposition to mental illness is the biggest risk factor. Genetics largely determine if a person will develop schizophrenia, depression, substance use disorder, etc. About 40-60% of mental illness is determined by biology.

Physiological factors (such as structural differences or chemical abnormalities in the brain) are another risk factor. Additional biological risk factors include prenatal damage, brain injury or defects, illness or exposure to toxins, and damage from drug and alcohol use.

Environmental and social factors include fetal exposure to a toxin and childhood trauma, among others.

Childhood abuse and neglect undoubtedly fall into the ‘bad parenting’ category. What’s more, adverse childhood experiences (ACEs) are associated with chronic disease, obesity, decreased immune function, substance use, and mental illness in adulthood.

While childhood abuse, neglect, and even spanking are linked to poorer mental health outcomes, bad parenting does not cause mental illness. Bad parenting can be a risk factor, depending on severity and impact, as well as the presence or absence of protective factors. (Protective factors include resiliency, health, feeling safe at home, etc.) Also, ‘bad’ parenting is somewhat subjective.

Generally, the more risk factors (and fewer protective factors) a person has, the more likely they are to develop a mental illness.

2. Mental illness is not a medical disease.

MYTH

Heart disease affects the heart. Colon cancer affects the colon. Autoimmune disorders affect the immune system. Brain disorders (i.e. mental illness, addiction, brain cancer, dementia, Parkinson’s, Alzheimer’s, etc.) affect the brain.

Like other organs, the brain is susceptible to disease. Brain disease manifests as changes in behaviors, thoughts, memory/processing, speech, emotional regulation, judgment, and more. Because your brain is the body’s control system, brain disease may also impact balance, muscle coordination, the ability to use your sense of taste, smell, touch, etc.

You cannot ‘see’ mental health symptoms the way you can see some physical health symptoms (such a rash or a broken bone), but you also don’t see most physical health symptoms.

When you have a headache, no one else can see it. You don’t even know what’s happening to the neurotransmitters and synapses across the lobes in your brain. You’re solely responsible for describing the pain to your doctor so they can prescribe the right treatment.

In reality, there’s not such a huge distinction between so-called physical and mental illnesses. They can both be painful and debilitating, and may require medical treatment.

3. All sociopaths are dangerous.

MISCONCEPTION

The term ‘sociopath’ (or psychopath) is frequently associated with serial killers. The reality is that you probably know a sociopath and they aren’t a murderer.

In fact, ‘sociopathy’ and ‘psychopathy’ are no longer recognized as diagnoses in the mental health world due to negative connotations. The diagnosis became associated with a sterotypical portrayal of a psychopath as a ruthless and insane serial killer. The stereotype is perpetuated by filmakers and TV producers and continues to show up in movies and series even today, despite the glaring inaccuracies with the diagnosis.

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.

MYTH

This is 100% myth. The notion that mental illness can be overcome with willpower 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 will not help someone overcome heart disease. And it does not work that way with mental illness either.

5. Addiction is a choice.

MYTH

Substance use disorder is no more of a choice than diabetes or cancer. Like most diseases, addiction develops when a combination of genetic, physiological, psychological, and environmental factors are present. Lifestyle choices also play a role. Unfortunately, the myth that addiction is a moral failing persists.

An individual who has an addiction receives more blame than someone with a heart condition, even though lifestyle choices heavily impact both disorders. I have even heard the argument that addicts who overdose should not be revived because it was their ‘choice’ to use. If that is the logic, then should we stop providing life saving care to someone who is obese when they have 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 is what it is like to be addicted to something.)

Having a substance use disorder is miserable, lonely, and shameful. No one chooses that.

6. People with mental illness are violent.

MISCONCEPTION

Having a mental illness does not make someone more likely to commit a crime or act of violence, especially if that person is following treatment recommendations for psychotherapy, medication, etc. Rather, biolocial, psychological, and environmental factors are associated with violent behavior. In the general population, younger males in lower socioeconomic classes with lower levels of education and employment are the most likely to engage in violent acts, not persons with mental illness.

While the media would have us believe that mental illness is at the root of every mass shooting, this isn’t the case. Most people with mental health problems do not commit violent acts or crimes, and most violent acts are not committed by people with mental illness. It’s also true that persons with severe mental illness are more likely to be victims of crime.

Moreover, 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.

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.

MISCONCEPTION

I am friends with a nurse who did not 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 is difficult to focus on a conversation when you’re having racing thoughts or hearing voices.)

8. A person with schizophrenia has multiple personalities.

MYTH

A person with schizophrenia may hear voices and even respond to what they hear, but they do not have multiple personalities. Multiple personality disorder (MPD), on the other hand, is associated with distinct personalities.

Today, MPD is referred to as dissociative identity disorder (DID). A person with DID has at least two distinct personality states, and suffers from gaps in memory. The prevalence of DID is largely unknown, but it’s estimated that 1-2% of Americans have DID. DID occurs so rarely that its existence was once disputed in the scientific community. There is a strong correlation between DID and childhood trauma and abuse.

With schizophrenia, the voices may be distinct, have their own names, and can be experienced as different personalities (male, female, child adult, friendly, cruel, etc.) or entities, but someone with schizophrenia has only one personality. Dissociation is not a typical symptom of schizophrenia.

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 is typically present in someone without schizophrenia. For example, a person with schizophrenia may be socially withdrawn or he/she may seem very flat, or without emotion.

9. Alcohol makes you depressed because it is a depressant.

MISCONCEPTION

Yes, alcohol is a depressant. As a depressant, it depresses your central nervous system, leading to slurred speech, trouble with coordination, etc. The intoxicating effects of alcohol are not symptoms of depression.

However, heavy alcohol use is associated with depression and other mental disorders. Someone who has depression or anxiety may drink to self-medicate. Alternatively, someone with an alcohol use disorder may develop depression, as alcohol upsets the chemical balance in the brain. What’s more, a person may regret the things they do while intoxicated, leading to intense guilt, shame, and/or hopelessness.


Help to fight stigma and misconceptions about mental illness by sharing this!

misconceptions about mental illness