The Assumptive Worlds of Psychopathy VIII: Embracing Shame and Guilt—Unraveling the Stigma Surrounding Mental Illness
As Kendell’s story illustrates, the guilt, shame, and stigma surrounding mental illness can be quite devastating to the patient. Mental illness can also be incredibly upsetting and overwhelming for family members. Our culture still paints a misunderstood, damaging and sometimes scary picture of mental illness, especially when it is paired with dementia. Christy’s Mother, Linda, has a debilitating illness called Alzheimer’s disease which was diagnosed back in 2012. The road she has traveled with her Mother has been nothing less than heart-wrenching, moving back and forth from crisis to crisis. Even though today the DSM 5 further defines the term “dementia” as major or mild neurocognitive disorder, there are still stigmas and misunderstandings about both mental illness and dementia. This is probably because dementia has been linked to mental illness in earlier versions of the DSM, and individuals with dementia clearly have cognitive impairments that share psychiatric tendencies. The term Neurocognitive Disorder focuses more on the decline, rather than the deficits. This is because Alzheimer’s disease is progressive and considered a neurological and degenerative disorder. It is hoped that this change in DSM name classification, will reduce the stigma attached to this disease.
When one is exhibiting noticeable memory impairment, errors in judgement, and cognitive issues, other people who do not understand the disease and the mental problems that ensue are typically not convinced that the afflicted individual has a problem. They are simply labeled as “crazy”. When we wrote earlier about how there are mechanisms that fuel stigma, we noted that people justify what they believe is true. This boosts the non-stigmatized person’s self-esteem as well as decreasing their own feelings of anxiety regarding their own demise. Christy found this to be true with her Mother.
There is also the matter of accepting the diagnosis. Some people would say to Christy, “it doesn’t seem like Alzheimers. I knew someone that had it and their symptoms were different”. Much as in the case of Lyme Disease, Alzheimer’s disease and its symptoms present themselves in different ways. Because of this lack of understanding, it is challenging for the caregiver to convince a healthcare provider of their needs. Even family members who don’t understand might tend to ostracize the caregiver, “siding” with their loved one. Actually, they are in deep denial that there is a problem, and when this disease goes unnoticed it can progress rapidly. In her personal experience with her Mother, Christy noticed a general lack of understanding as to the stage and severity of her mother’s decline. This was because her Mother was able to mask those key symptoms that were psychiatric in nature.