One of the most important aspect of my work as a psychiatrist has been advocating for my patients. This advocacy has needed to be persistent and constant because society is very quick to blame the mentally ill for their impairment. Over the years my job has been to speak for my patients’ rights and needs. Sometimes it has been in the disability form to Social Security Administration , sometimes it has been to an employer who labeled my depressed patient as “lazy,” and sometimes to a judge trying to deny a mentally ill mom, the custody of her children. The scars of mental illness cannot be seen but they run deep, encompassing all aspects of an individual’s life.
According to National Alliance on Mental Illness (NAMI), one in five Americans lives with a mental illness and one in 25 adults will suffer from a serious mental illness like Schizophrenia. Practicing psychiatry, I have truly understood the pain and suffering of having had a mental illness through the eyes of my patients. Suffering is universal to illness and mental illness is no exception.
As a cancer patient myself, I have understood suffering both physical and mental in an exceptional and intimate ways. Over the last four years, I have heard my share of insensitive comments about my cancer, comments like “Oh well, at least you get a free boob job!” or “You used to look so ‘chemically’ in treatment.” However, no one has ever used cancer as an insult.
It is not in our vocabulary to demean people by using physical illness as a way of ridicule, but time and time again, mental illness is used as a way to make fun of others. When we use labels, it leads to separation of us versus them. The more labels we use, the more fundamentally different they become from us. This in turn makes prejudice and discrimination easier to follow. It is common to call someone a “schizophrenic,” an illness becoming their defining feature. But when we meet someone with cancer, we say “person having cancer.” Thus cancer is just an attribute and not a complete identity. Labeling those with mental illness runs the risk of dehumanizing them completely leaving them more vulnerable by mere use of wrong language.
Those with mental illness therefore suffer doubly. First, at the hands of the illness itself, dealing with the relentless symptoms, and then at discrimination against them at the hands of others due to their mental illness. The attitude of others isolates and victimizes them further. Public stigma is a huge problem in mental illness and likely to affect an individual’s well being, employment, housing and acceptance in the community.
So when I heard that one government official had called another government official a paranoid Schizophrenic, I was hurt and angered. I don’t claim to understand exactly what the intention or reason was, but as a person who cares deeply about those with mental illness, I find this intensely offensive. I am offended for my patients, who wake up every day in this world and battle the cruel illness of Schizophrenia. I am offended for the parents of my patients, who put everything aside to care for their children with paranoid schizophrenia. I am offended for the children of my patients, who see the impact of this illness on their mom and dad and how this illness tortures them. I am offended for all the mental health care providers, therapists and psychiatrists who spend their entire careers fighting this stigma every day. I am offended for all mental health advocates who protest long and hard against prejudice and discrimination on behalf of those with mental illness.
Paranoid Schizophrenia is not a self inflicted character weakness but a bona fide mental illness, often demonized and portrayed negatively in the media. It’s a chronic brain disorder that affects about one percent of the population all over the world. Schizophrenia is an illness that can be characterized by hallucinations and delusions in its active phase but it is a chronic illness, with episodes of severe symptoms interspersed with periods of improvement. It can be well managed by treatment including therapy and medication. Most patients with schizophrenia are not violent and schizophrenia does not mean a split personality. Schizophrenia is one of the top ten causes of disability in the developed countries.
The torment of psychotic paranoia is also rarely understood. Imagine living in a world where you do not feel safe and feel like everyone would like to harm you? Can you imagine the pain of being in such a situation, where you are afraid to eat and drink for the fear that it may be poisoned? Being paranoid as a trivial social term is very different than paranoia of mental illness. It is irresponsible to throw such terms around without attention to the seriousness of such words.
The stigma of mental illness remains prevalent and remains a barrier for seeking care. Over the years, NAMI has been in the forefront of reducing this stigma but only consumer groups alone cannot do this. The responsibility lies with all of us. Stigma diminishes the quality of life of patients with schizophrenia. In 1996, the World Psychiatric Association launched a campaign to reduce the stigma of Schizophrenia specifically and here we are twenty years later, using terms like “paranoid schizophrenic” as a demeaning insult.
We ought to be moving in a direction so more people feel comfortable seeking the help they need by condemning and protesting such irresponsible narratives. We need to support those with mental illness and for that, we as a collective need to protest any prejudice and discrimination including using mental illness diagnoses as insults. We owe it to the mentally ill, we owe it to ourselves and we owe it to our society.