Demystifying depression and other mental illnesses
The portrayal of the mentally ill as being weak is an example of gross misapprehension of the nature of mental illness. Photo: Thinkstock
In March this year, a Germanwings pilot crashed an Airbus A320 in the French Alps, killing all on board. Then, in May, a maid was jailed for 12 years in Singapore for strangling a teenaged girl with a pinafore.
What do these two events have in common? In the former, the pilot was receiving treatment for depression and harboured suicidal tendencies. In the latter, the maid had severe depression with psychotic features, which impaired her judgment.
Psychiatry is more associated with crime than with any other medical discipline, hence the need for a specialised forensic psychiatry branch. This gives rise to questions which are often nebulous. For instance, how do we draw the line between sanity and insanity? Under what circumstances should one be offered a lighter sentence on the grounds of diminished responsibility?
This year’s theme for World Mental Health Day (Oct 10, 2015) is “Dignity in Mental Health”. Criminals who are deemed to possess diminished mental acuity as a result of illness often get evaluated by forensic psychiatrists, in order to pay their condition due regard and accord them their due dignity.
However, we often forget that dignity is something that mentally ill people ought to have on a daily basis.
To be fair, the history of psychiatry has contributed to the stigma that exists today. Back then, mentally ill people were subjected to barbaric treatment which included physical torture, among others.
The discovery of chlorpromazine and lithium carbonate in the 1950s, while revolutionising the treatment of mental disorders, did little to dispel the public’s negative perceptions towards mental illness.
The perception of mental illness as being in the domain of the supernatural has always been a perennial dictum passed down from generation to generation, running contrary to the idea that treatment is necessary.
But what probably compounded matters was the sometimes inaccurate portrayal of mental illness by the media which engenders misconceptions.
Stories of psychopaths committing murders and other brutal crimes, for example, strongly insinuate the violent nature of the mentally ill. The portrayal of the mentally ill as being weak is another example of gross misapprehension of the nature of mental illness. These misconceptions then perpetuated over the years, giving rise to the pernicious stigma.
REMOVING THE STIGMA TO PSYCHIATRY
Today, psychiatry is still very much seen as an oppressive branch of medicine, one in which the patient is usurped of his or her basic rights.
But the reality is that mental disorders are a major cause of disability (major depression ranks first according to the World Health Organization). Mental disorders are often an encumbrance to someone looking for employment. This is just one way someone with mental illness may suffer from a loss of dignity in daily life.
Depression, for example, takes a toll on one not only mentally, but also physically and socially. It is an enervating disease which causes sufferers to see a world of darkness, sometimes significantly impairing their daily functioning.
The lack of understanding, coupled with the misconceptions surrounding mental illness, sometimes leads to a more severe loss of dignity including being labelled and ostracised by their peers or friends.
Definitely, the sanctity of one’s inviolable rights demands that he be accorded the same dignity as everyone else. A mentally ill person does not mean that he or she is incapable; neither does it mean that character flaws are present in him or her.
In her book “Is there no place for me?”, Australian doctor Kate Richards, who experienced episodes of depression and psychosis into her adult life, asserts that the current system of mental health care is reactive rather than proactive, and is akin to how an infection spreads through the bloodstream and becomes life-threatening septicaemia before admission is warranted.
She also contends how mental health patients ought to receive due dignity. What she says cannot be more true. Indeed, it is only when mental health patients are given a voice, respected and understood, will their recovery be a propitious one. Friends and family can offer support to the individual in small ways, and, in particular, the act of listening and giving love are two understated yet potent ways.
Efforts to destigmatise and educate the public on mental illness, though in their nascent stage, have been gaining momentum in Singapore recently, with many new initiatives such as the mental health-care programme Assessment and Shared Care Teams (Ascat) launched in 2013.
It involves working with organisations in the community like family service centres and making mental health care more accessible within the community. Hopefully, with the unwavering support of mental health professionals and their pertinacious efforts, mental illness can be demystified and less shrouded in misunderstanding.
Let us work towards a mental health system which preserves the dignity of mental health patients, one in which they will not be judged or traduced on the basis of their condition, and one that encourages treatment instead of breeding insecurities. Let us, in Dr Richards’ words, create “a place for us where we can be engaged with the world in a way that gives us a sense of purpose ... a place where things are born, where they begin”.
Had the pilot and the maid been accorded more dignity, perhaps these human disasters which resulted in so much anguish could have been averted.
The torment of the human mind is certainly understated, yet we often fail to respect these individuals afflicted with mental illness, and instead ignore, or even support the system that strips them of their dignity and leave them bare and devoid of self-esteem.
Mental affliction is no less palpable than physical pain and it is lamentable and heart-wrenching that society remains partial in its treatment of these very different, yet similarly distressed groups of patients.
ABOUT THE AUTHORS:
Aaron Low is a third-year undergraduate of Singapore Management University. Chow Zhi Wan is a third-year undergraduate of the National University of Singapore. Both have a keen interest in mental health issues.
