Coming out of the crazy closet

Although we still don't understand much about the most complex object in the universe (i.e. the human brain), we're a bit less ignorant about it than we used to be.

We know the mind has a physical, biological genesis in the brain, which can get damaged and sick like any other organ. We know mental illness is real, common and serious, just like heart disease or cancer. We know it's no more our fault if we get obsessive compulsive disorder than if we get multiple sclerosis. We know that coming out about being a sufferer is vital in fighting stigma and misconception. High profile sufferers who speak out such as Stephen Fry and Catherine-Zeta Jones (both have milder forms of bipolar disorder) do a great service in this respect.

Yet despite knowing all this, it remains very tricky to come out about having a clinical diagnosis, let alone waving the mental health advocacy flag on high. On top of the shame and failure for having a mental illness (nearly all sufferers feel this to some degree), there’s now a sense of failure if you’re keeping it hidden. You feel shame for feeling ashamed.

Mental illness is different

No one should be persuaded they’ve let the cause down if they’re not ready to disclose their mental health history. Because mental illness isn’t, in fact, “just like heart disease or cancer”.

For one thing, the stigma is still considerable, and each time you disclose your illness you’re risking getting one of these (worst case scenario) responses:

1.    Now that I know you’re a crazy person I don’t want to be your friend/employ you. I no longer trust you.

2.    I don’t believe you have a legitimate illness. You’re shamming, or malingering, or looking for undeserved sympathy. You’re weak/lazy/pathetic. I don’t want to be your friend/employ you.

Generally, celebrities are risking a lot less than you or I when they self-disclose. Fry is hardly going to lose work because of it, or Zeta-Jones friends and acquaintances (and even if they did, they’re unlikely to care much at this point in their stellar careers).

But stigma is only part of why mental illness is different. Although enduring any major illness will change you and might well affect your personality, mental illnesses like depression are entwined with your selfhood in deeply complicated ways. It’s like an invisible, insidious parasite that hides in the electrical impulses of the brain and becomes one with its host. Successful recovery requires separating the disease from who you really are without it. There are of course neurological diseases such as brain tumours and Alzheimer’s where the true self can also become lost. But because these can be diagnosed with objective tests, we find it easier to think of them as foreign entities attacking the patient. With mental illness, it is much harder to tell, both for the patient and those around him or her, where he/she ends and the disease begins. This is partly why the patient feels ashamed of being sick – the illness feels like it is part of the self, and generated by the self. It feels like it’s your fault.

So disclosure, admirable as it is, isn’t something anyone should feel rushed into doing. When considering it, these points (gleaned from the research into the risks and advantages) may be helpful:

  • As with any fairly weighty revelation, you don’t have to tell everyone. Start with those close to you, whom you trust. Not everyone needs to know your medical history.
  • It’s probably best not to tell your employer unless it’s necessary e.g. if you need to take off work for hospitalisation.
  • You don’t have to Tell All, all at once, in complete detail.
  • Disclosure will likely bring a sense of relief, and aids with recovery. It also often leads to finding others with similar experiences.
  • Know that disclosure is a courageous, activist step that helps others. Research shows that in most cases, knowing someone with a mental illness dramatically improves a person’s attitude toward mental illness generally.
  • Not everyone you tell will react well, but you might be pleasantly surprised by how many people respond with not 1. or 2. above, but with
3.    I’m so glad you told me: Respect. You know, I’ve had a brush with mental illness myself, let me tell you…

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