Breaking The Stigma of Mental Illness

Clinical Nutritionist, BROOKE BENSON CAMPBELL (BHSC Nut Med) talks about her experience with mental illness and questions the way we talk about it and the effect it has on all aspects of our lives…

Late legendary musician John Lennon once said, “Life is what happens to you when you are busy making other plans”, and for most of us, this is true. But for those who have suffered some form of mental illness, life can appear to exist in a vacuum – a limbo of sorts – limited socially by prejudice and perception, and individually by self-criticism and deprecation. With the goal of transparency and reflection, here I’d like to share my experience with mental illness in order to knock down the social and self-made barriers and fight the stigma, forcing us to question the way we talk about mental illness and the effect it has on all aspects of our lives.

For years, my career as a Clinical Nutritionist has combined knowledge gained through university study and gathered from years of clinical practice that specialised in mental health and the brain, with my own personal experience of wading through the depths of my own major depressive disorder. I am innately aware of the rollercoaster of anger and resentment, the numbness of deep despair and the resultant self-loathing that comes from suffering with a mental illness. I am cognizant of the person able to function throughout immense pain and confusion and the stigma surrounding mental illness that touches every facet of their life, from familial relationships to chapters of their career. I am sensitive to societal attitudes and casual language that views mental illness as weakness and lack of strength, and I applaud anyone who steps forward to share their own journey with the goal of increasing awareness in the pursuit of acceptance and understanding. Most importantly, I stand with every one touched by mental illness to beg for a change in our collective approach to mental health that is so desperately needed.

Whilst we have made gains in our understanding of mental illness over the past few decades and huge strides in treatment of mental illness with therapy, medication, nutrition and supplemental medicine, some people with depression, anxiety, schizophrenia, bipolar disorder and other mental illnesses still encounter public stigma that robs them of opportunities to define a quality life. In fact, 75% of people with a mental illness report that they have experienced stigma – not surprising when you consider the results of a study published in the Journal of Health and Social Behaviour that interviewed 250 members of the public and their opinions concerning people suffering from mental illness: 56% of people interviewed for the study did not want to spend an evening socialising with someone with a mental illness, while 58% of people did not want to work with someone with mental illness. These statistics are particularly shocking when you consider that one in seven Australians will experience depression, one in four will experience an anxiety condition and almost half of all Australians (45%) will experience some form of mental illness during their lifetime.

I know from the response I’ve received from public admissions of my illness that there needs to be a counter-image to what most people think of when they think of mental illness (and in my case, major depressive disorder): the image of the “crazy” person who cannot control their emotions, are constantly negative and “woe is me” and cannot function in daily life. People need to understand that people with mental illness can thrive and achieve, create and succeed. We are not mentally weak, we are survivors; capable of having a “bad day” without falling off the proverbial cliff, and that our symptoms can be managed perfectly like the symptoms of many other chronic illnesses. We have close families, we have incredible careers, we have passion for our hobbies, and we live full and enthusiastic lives that we love (all of which appear to compete with the common stereotypes and stigmas of mental illness).

The word “stigma” originated in Ancient Greece and is derived from a word meaning “to mark someone”. Erving Goffman, in his seminal 1960s work ‘In Stigma: Notes of the Management of Spoiled identity’, describes the damaging effects of stigma, which reduces the bearer from a whole person to a shallow part – the part that is instantly defined. Stigma is not simply the use of negative labels or a poor choice of words; it encourages fear, mistrust and/or aggression towards people with mental illness. And most troubling, these negative opinions stay long after the symptoms of the illness have disappeared. As I know too well, the impact of stigma is twofold: public stigma is the reaction that the general population show to mental illness, and self-stigma is the loathing in which people with mental illness turn against themselves.

Personally, self-stigma was very apparent through my mental illness – I fell into many of the traps common for a 20 year old suffering major depression: for several years I hid in a haze of self-medication of alcohol, party drugs and sex (all under the guise of a rock & roll lifestyle). I was increasingly reckless and insolent, constantly pushing boundaries and loyalties in subconscious self-punishment; completely terrified of a fundamental numbness that was slowly smothering my sense of self. The hysterical angry crying sprees that many associate with depression and mental illness gave way to an endless search for feeling through heightened experience – for ANY feeling, good or bad, that would remind me that I was still living and breathing and experiencing the world around me. Stigma is an incredibly powerful thing, and regardless of type, it undoubtedly yields two kinds of harm that can impede treatment and recovery: it diminishes already fragile self-esteem and it robs people of social participation.

Interestingly, entrepreneurs are one group most affected by mental illness – in fact, one in 10 small business owners will experience some form of mental illness during their career. Long (or endless) working hours, lack of sleep, lack of financial support, isolation and poor nutrition all contribute to depression and anxiety – at the very least creating innate loneliness and heightened stress levels, and at the most, turning on genetic switches that carry predisposition for mental illness. In a culture of competition and public persona, it is very difficult for people in small business to admit when things aren’t good – maintenance of the smokescreen remains a critical part of the charade – and this can also cause disillusionment and uncertainty. An awareness of self-care and psychological wellbeing is an essential component of the modern business plan to enable entrepreneurs longevity and productivity in business.

For business leaders, neuroscience proves that employees crave three things: to feel safe, to feel they belong and to feel they matter. When organisations provide these, employee loyalty has been shown to double. Organisations that foster cultures of trust report 74% less stress, 106% more energy at work, 50% higher productivity, 13% fewer sick days and 40% less burnout. This is highly significant, as the 2018 KPMG and Mental Health Australia report, Investing to Save, found that mental illness in the workplace costs an average of $3,200 per employee, and overall it was estimated that the cost of workplace mental ill-health in Australia was $12.8 billion in 2015-2016. By broadening our discussion around mental illness and the importance of psychological wellbeing, we can impact the workplace, industry and the economy, while taking care of our most important resource – our people.

A commonly held public belief is that people with mental illnesses are in control of their disabilities and are at least partially responsible for causing them. It is well-understood that when someone shares that they have been diagnosed with a physical illness like multiple sclerosis or forms of cancer no-one says, “You should just think positively” or “Stop the ‘poor me’ act. We all have problems”. Nor do they counter the announcement with, “That’s not true. You are just looking for an excuse to be lazy”. And yet, all three comments have been made to me throughout the course of my illness – some by a close member of my immediate family – and have no doubt been made to many others. And it is here that the true injustice of mental illness lies. For those who have had cancer, they are a “cancer survivor” and people celebrate being cancer-free. For those who have beaten a form of addiction, being sober is counted in days and years and people are deservedly proud of being substance free. Yet for those of us who have suffered some form of mental illness, we have not yet been given permission to celebrate our victory, to revel in the hard-fought recovery and to be publically acknowledged for being strong enough to resist the involuntary temptation of relapse. Our days and years are not counted, even though we too are constantly working on recovery.

Through years of self-experimentation, I have done what many of those with mental illness have done. With clinical research and plenty of trial and error, I have developed a personalised regime that fits into my daily life to balance my predisposition towards self-criticism and promote healthy brain pathways to counter chemical and inflammatory imbalance. In the same way that people living with high blood pressure or high cholesterol have done, I have altered my diet and way of living to treat my condition and I maintain a healthy awareness of the possibility of a relapse (however small) at some point in the future. Exercise plays a major role in my mental wellbeing and my ability to process and relive stress. For me, TRX and Barre provide a solace of meditative release through movement that shuts down my overactive brain and reduces my naturally high cortisol levels. A supplementation routine enhances function of brain pathways to boost function in compensation for slow reuptake of serotonin; an activated B vitamin blend supports neurotransmitter production of my “happy” brain chemicals and a daily dose of magnesium gluconate enhances GABA production to promote feelings of calm relaxation. My diet is based on the Paleo regime, that cuts out inflammatory gluten and dairy and boosts amino acids needed for neurotransmitter production and detoxification, and most importantly I now do something that my once Type-A “burn the candle at both ends” personality would not allow – I take time off. I relish the weekend, I sleep when I’m tired (even if that does mean heading to bed at 8.30pm) and I embrace holidays as periods of essential self-care and mental recharge.

I am not alone with such a detailed self-prescription and in fact, most people with a history of mental illness will have their own boundaries, routines and limitations in place for the purpose of self-treatment. To support our friends, family members and colleagues with mental illness, these forms of treatment should be equally supported and respected as alternative and supportive forms of therapy – sadly to date, gym memberships, nutrition supplements and other alternative self-care methods like massage and yoga are available to a select few due to associated costs. We need to make self-care an approachable and realistic goal for all members of our society.

It is important that we collectively view mental illness as a challenge, not a weakness. When we

all acknowledge the importance of our mental health, we get to know ourselves better, and are more authentic people, employees and leaders. Mental health IS physical health, and similarly mental illness IS physical illness – and understanding this fundamental truth can only help to cut through existing stigma.

Often ignorance perpetuates stereotypes around mental illness, so education is an essential way to fight common stigma. Collectively, we need to learn about various types of mental illness and the ways they may manifest. We need to ask others about their mental health experience and path to recovery. When we put a familiar face to an illness, we humanise it and make it relatable.

SIGNS & SYMPTOMS

To use Major Depressive Disorder as an example – MDD is defined by the Diagnostic and Statistical Manual of Mental Disorders in technical terms as “five or more symptoms during the same two-week period and at least one of the symptoms should be either 1) Depressed mood; or 2) Loss of interest or pleasure:

Depressed mood most of the day, nearly every day.
Markedly diminished interest or pleasure in all activities.
Significant weight loss when not dieting or weight gain/change in appetite.
A slowing down of thought and reduction of physical movement observable by others.
Fatigue or loss of energy.
Feelings of worthlessness or excessive or inappropriate guilt.
Diminished ability to think or concentrate or indecisiveness.
Recurrent thoughts of death or suicidal ideation or a suicide attempt.

However, mental illness is not about ticking boxes of symptoms. For me, it is about human experience. I can only tell MY story of being unable to leave my home for months on end, unable to bring myself to open the front door, unable to participate in the joy of daily life and unable to feel regret for this due to an aching hopelessness that had overcome my physical body; my brain begging my body for the energy to end my suffering, but with a tiny voice of strength that encouraged me to dismiss the demand. A mind full of fog, unable to trust its own thoughts and decisions, and emotions – at once both heightened and non-existent- in a skeleton of hollow bones that was only motivated to movement by the one thing I could still muster love for: my innocent one-year-old puppy, Mabel. I can also only tell of my story in slowly regaining parts of myself I thought lost to the illness, rediscovering my loves and passions and re-establishing self trust. I can only talk of learning to embrace my strengths and weaknesses without judgment in order to feel a sense of pride and self-awareness known to few. Each and every person who has experienced a form of mental illness has such a story, and these are the stories that matter. It is the human experiences that lie within the black and white clinical definitions that can boost our collective understanding and acceptance of mental illness, and that can allow us to be part of the solution, rather than the problem.

We also need to create and foster safe spaces so that people can speak about their psychological challenges and victories (both past and present) without fear of prejudice or judgment. We need to encourage a dialogue that talks openly about treatment and recovery. We should fill the storybooks with powerful and successful people that have been open about their mental health issues, and not only survived, but thrived through illness. Dwayne ‘The Rock’ Johnson, Jim Carrey, J.K.Rowling and Winston Churchill have all have admitted to suffering from various forms of mental illness throughout their lives while carving successful and illustrious careers.

We need to be careful with the words we use – we should not be accepting of mental illness being used as an adjective eg. “She’s totally schizo today”, and terms like, “crazy” and “cuckoo” should no longer be a common part of our casual language. As a society, we need to accept that incorrect use of words only encourages wrongful stereotypes and promotes stigma. Furthermore, we need to take responsibility for the fact that such terms have the potential to hurt others that are in a fragile state of mind.

For me, true healing arrived many years after the symptoms of my illness subsided, and the key lay in self-forgiveness. Forgiveness of actions beyond my control, acknowledgement of grief for the important years of my life spent under the blanket of depression and acceptance that those years took their toll not only on my physical self, but on long-term relationships with family and friends were things essential to my recovery. Still, to this day, I wonder what my life would have been like without my illness and yet I’m finally able to embrace the journey – it has made me the person and practitioner I am today, and for that I will always be grateful. All that is left is to continue to be transparent about my own struggles in the hope that little by little, and together, we can change the dialogue around mental illness. Together we can fight the stigma. Just as a mental illness has many symptoms, and a treatment plan many steps, we need to draw on the many facets of public life to fight the stigma against mental illness to enhance the lives of all Australians – those with mental illness, and those without.

ABOUT BROOKE

Brooke Benson Campbell (BHSc) is a Clinical Nutritionist and Naturopath, speaker, writer and presenter with a passion for all things health, beauty and wellbeing. A self-proclaimed human test subject, she is constantly trialling the newest products, seeking the latest discoveries and reading the current clinical studies, in order to share her findings with the public through private practice, social media and industry education. Follow Brooke at her Instagram @the.b.b.c