Mental illness is no joke

"I'm sorry I screamed at you - I have anger control issues." "I can't sit in this meeting - my ADHD is kicking in." "I hate my job - it's so depressing." "I hate when the kids mess up the house - I'm OCD." "I'm about to go mental." "I'm about to go psycho." "You're narcissistic." "You're retarded." "This might be schizophrenic thinking but..." "You're so anal." "Are you insane?" "I can't remember where I left the keys - I must have Alzheimer's." QUIT!

Mental illness is not a catch phrase. Mental illness is not funny or topical. Psychological disorders are not a way to express one's temporary sadness, inattentiveness, forgetfulness or lack of mental awareness. True mental illness is extremely maladaptive behavior, which substantially interferes in one's life and makes that life difficult or impossible to live. Mental illness is not a joke or light conversation and when labeled with a disorder, one lives the life of that disorder. The label makes the person.

When people describe themselves as depressed, anxious or obsessive they are placing themselves in the position of the disorder. The disorder controls them. A healthier way of describing a person with a disorder is to say Jane has depression instead of saying Jane is depressed. Jane is more important than the disorder and therefore has the disorder and is not the disorder.

When we generalize mental illness and speak of it in conversational terms, we are making the statement that, "everyone is sick and requires medical or psychiatric attention." It is important to remove psychological speak from our vernacular. Instead of saying, "I'm depressed," one might say, "I'm sad." Sadness is a true descriptor of the up and downs of daily activity.

It's OK to be sad. Sadness is a normal human condition but not a psychological disorder. Constant sadness or low mood is called dysthimia - low-mood depression. Many people live in a world of low mood depression and are successful in their work and enjoy life. This is not a disorder. For dysthimia to be a disorder, one must not be able to participate in life as they wish due to the disorder.

Cyclothymia is the cycling of human emotion from slightly depressed to slightly manic. This disorder describes many Americans who are considered, "moody." Again, if these symptoms do not substantially interfere in one's life, it is not a disorder.

The problem. Many people I see in my office diagnosed with major or bipolar depression have cyclothymia or dysthimia and are not disordered. Being labeled as a person with depression offers many reasons to live down to the diagnosis.

The label of depression is easily misunderstood, overused and can result in a self-fulfilling prophecy. If a patient is labeled with depression, they might use the label as an excuse to avoid joyful situations, to be cranky or not go to work. A patient might struggle with life issues but therapy or self-enrichment instead of psychopharmacology is the answer. Television, newspaper and magazine drug advisements offer short information bites, which raise questions that can only be answered by a medical doctor.

The American oddity of advertising pharmacological medication does not aid but only exacerbates the labeling effect. Advertisements are meant to sell products to consumers. For a consumer to purchase a product they must feel a need or desire to make that purchase and advertisers focus on making us desire things we don't need. When an advertisement asks if you "feel like a rain cloud is hanging over your head," or if, "you have had a low mood for two or more weeks." One might question if a pill will make the sadness go away instead of questioning the cause for the sadness.

Pharmacological advertisements have created a new world of labels. Many disorders described in advertisement where not disorders prior to the advertisement. Example, GlaxoSmithKline took the notion of shyness and turned it into social anxiety disorder. They hired the public relations firm Cohn & Wolfe to help establish social anxiety disorder as a way of cultivating the marketplace even before the launch of their drug Paxil. They created hype around a disorder in order to sell a drug. Their claim that one in every eight Americans have social anxiety disorder is much higher than the less than 1 percent of sufferers agreed upon by most mental health professionals.

Let's examine four experiments on labeling. In a controversial demonstration of the biasing power of diagnostic labels, David Rosenhan and seven others went to a mental hospital admissions office complaining of hearing voices that were saying empty, hollow and thud. Apart from this complaint all answered questions truthfully. All eight were diagnosed as mentally ill and held in the hospital an average of 19 days with no further symptoms.

Psychologist Ellen Langer had people watch a videotape job interview. Some were told the interviewee was normal. Others were told the person was a psychiatric patient. Those who watched unlabeled interviewees perceived them as normal; those who watched supposed psychiatric patients perceived them as different from most people.

Another psychologist, Stewart Page, called 180 people in Toronto who were advertising furnished rooms for rent. When he asked if the room was still available, the answer was nearly always yes. When he said she was about to be released from a mental hospital, the answer three times out of four was no.

Labels can change reality. In a classic experiment on teacher expectation, a third-grade teacher is told the students in her school will be ranked from highest achieving to lowest achieving and her classroom will be filled with the highest achieving students in third grade. Halfway through the year, her students achieved to their expectation and are the highest achieving students in all third-grade classrooms. At this time the principal explains, "There's been a terrible mistake. We ranked the kids in the wrong direction and the children we thought were the high achieving are actually the lowest achieving."

Living up to their new label, scores on standardized tests quickly began to dive and the recently high achieving students became the lowest achieving students by the end of the school year.

Labels do make the person. It feels good to be called smart, hardworking, capable and high achieving. It does not feel good to be called stupid, lazy, retarded, psycho, schizoid or insane. If told we are smart or dumb enough times we tend to live up or down to the label. Living down to a demeaning label creates learned helplessness and living up to a positive label creates positive thinking and behavior.

Bill Rutherford is a psychotherapist, public speaker, elementary school counselor, adjunct college psychology instructor and executive chef, and owner of Rutherford Education Group. Please e-mail him at bprutherford@hotmail.com and check out www.foodforthoughtcda.com.