Talking about mental health is always challenging, for it is an area of medicine rife with misconceptions and false information that seems to breed more myths than facts. And myths about the cause, diagnosis and treatment of psychiatric illness can have a very real effect on someone's chances of recovery. If you start feeling stigmatised and ashamed of your condition, it takes a lot of courage to take the first important step of seeking help.
In my work in mental health, I come across myths and misunderstandings every single day, and it is a constant struggle to put people right – but it is a vital one. For only by educating people and giving them the facts will we able to wipe out the stigma and fear that surrounds mental illness.
The most common myth is that people with mental health problems are crazy, a danger to themselves and others, who should be locked away in an asylum. All too often films and TV serials perpetuate this idea. In fact, admission to hospital is necessary only in extreme cases, and then usually for just a short time: after a successful course of treatment, patients are able to return home. The vast majority of people with mental health problems are capable of living successful and productive lives within the community.
Studies show that mental illness is caused by an imbalance in the chemistry of the brain. Like diabetes, cancer and heart disease, it has a biological basis, and – again like diabetes, cancer and heart disease, as well as almost any other illness – it can be successfully treated.
All too often, mental problems of every kind get lumped together. The common perception is that having learning difficulties is a form of mental illness, when in fact there is a vast difference between the two conditions. Learning difficulties are characterised by an impairment in intellectual function and problems carrying out everyday activities. Mental illness, by contrast, is a medical condition that causes changes in a person's thinking, mood and behaviour.
A basic misunderstanding about the medical nature of mental illness means that people are all too quick to apportion blame. Some see mental illness as the fault of the sufferer; others regard it as the result of bad parenting or even as an act of punishment from God. They fail to understand that a disorder of the brain is no less a medical condition than a disease of the heart or kidney.
While mental illness is fundamentally a physical condition, biological, psychological and social factors can all play a role. Research shows that psychiatric disorders such as schizophrenia and depression are mainly associated with genetic and biological factors. But people may become more vulnerable to mental illness if the environment in which they live is particularly stressful, or if they have experienced or simply witnessed a traumatic event. Social factors such as being out of work, being displaced from one's home, or the death of a loved one can have an effect, too, on one's psychological health.
What is certain is that mental illness is not a matter of choice; it is no one's fault, and is not caused by a person's actions; rather it is the result of changes in the environment or changes in the function of the brain.
One of the most prevalent delusions about mental illness is that it is irreversible, and a condition from which no one can recover. This is completely false; with the right treatment and support, recovery is a good possibility. Both medication and psychotherapy have a role to play, and many therapeutic interventions, community support systems and treatment plans have all been successful. Over time, patients respond positively to these treatments and many are helped to live stable lives.
Like any medical condition, mental illness has different levels of severity, and for some patients it can be long-term and persistent, but regular treatment – with medication, therapy or rehabilitation – can greatly improve a patient's quality of life.
Most people think that mental illness will never affect them. But, in reality, mental health problems are very common and can strike anyone, indiscriminately. People who live in conflict zones are particularly vulnerable because living in a state of constant insecurity increases anxiety levels and results in a much higher-than-average chance of developing mental illness.
Given that there is an alarming increase in the number of people with mental illnesses, it is important that the facts become more widely known and that the myths are forgotten. At present there is a risk of irrevocable damage being done to a section of society which should be receiving treatment but isn't.
There is much that can be done and everyone has a role in this. People must be discouraged from making fun of those who are ill as it only adds to the distress of a patient. Those with signs of a mental illness must be encouraged to seek help and be shown that there is no stigma or shame attached to their condition.
The more the facts, rather than the myths, become known, the quicker there can be a more constructive approach to this sensitive illness.
This article is a part of series of articles on mental health and the experiences of MSF mental health professionals in Kashmir to help people better understand mental health issues and reduce the stigma attached to them.
(Munazah Gulzar is working as a mental health counselor with Médecins Sans Frontières for their Kashmir project. Médecins Sans Frontières (MSF) or Doctors Without Borders is an international humanitarian medical aid organisation working in more than 70 countries worldwide. MSF is neutral, impartial, independent, and not linked to any political party or governmental body. Our teams provide emergency medical assistance to people in need, irrespective of their nationality, race or religion. In 1999 MSF was awarded the Nobel Peace Prize.)