The Double Standard of Mental Illness

APR. 25, 2018

By Michelle Walshe


Mental health conditions are not the only illnesses to suffer from stigma: AIDS, leprosy and obesity are others. However, Princess Diana shook hands and shook the world at the same time. Antibiotics took care of leprosy and obesity receives a lot of attention from the media. But mental health…it still languishes in the shadows.

It receives occasional celebrity glances, but I feel like these campaigns actually move mental health further away from understanding. The answer is not more exposure to mental health, but more education. First Aid, CPR and sexual education can be found in schools, gyms and offices. Yet CBT could be mistaken for a television channel and mindfulness still invokes eye-rolling.

Everyone should be minding their own mental health, but it’s also important to know the signs in others—which is hard to do if you don’t know what you’re looking for.

If a family member walked into your living room, bent over in pain and screaming for help, what would you do? You would help, of course. And generally, you’d know what to do. If you saw blood, you’d try to stop it. If the person was choking, you’d open their airway. You wouldn’t be performing surgery if that was required, but you could call a doctor or drive them to a hospital or go to a pharmacy and get painkillers.

But with mental health, the picture is so different. We don’t do any of the above. We generally ignore the symptoms, often only seeing them in hindsight. Then we say, “Cheer up!” “Things aren’t that bad!” “Look on the bright side!” In the same way that these phrases will not cure a burst appendix, they can’t cure a bout of depression either.

For the most part, but by no means always, a person experiencing mental illness will present as withdrawn, detached or dissociated from reality. But because they’re not screaming in pain or doubled over, we think (misguidedly) that a few feel-good phrases are the best medicine. But the real best way to help when you see these behavioral changes—no matter how subtle they may be—is to recognize that this is the scream you’re looking for. It’s silent, so you must be on high alert, but just like stroke symptoms, the faster you act, the better the outcome is going to be.


Sympathy and empathy is always with the person experiencing the mental illness. And rightly so. Mental illness often feels like being at the bottom of a well you cannot climb out of. And like any illness, you feel sick. Some days, you feel sick every minute.

But there is an army of people struggling as well because mental illness is one of the hardest, most frustrating, most guilt-inducing illnesses to care for. Every caregiver berates themselves for the time they lost their temper, their patience or their cool. Not to mention the guilt and the unease that travels with them every time they leave the house or if their phone rings unexpectedly—the permanency of being on edge, the constant companion that is worry.

But most of all, every caregiver carries the same gnawing question: What if they could have caught their loved one’s illness sooner? What if they missed something—a clue, a sign?

Caregivers and individuals are somehow both expected to recognize symptoms, understand them and then get ourselves or our loved ones the right kind of help in an area of medicine where even the professionals seem to struggle to diagnose clearly. But how can we do that if we’re not properly educated first?


Michelle Walshe teaches teenagers in a College of Further Education in Dublin. This is a full-time job, inside and outside the classroom. Any spare time she has, she spends reading and writing. Michelle has had a number of articles published in the national media in Ireland. She’d lived in America, Australia, Switzerland, Germany and Morocco but home is where her family is and that is Ireland. Michelle has spent the last year taking care of her mother, who experiences bipolar disorder. Check out her blog at


MAY, 11, 2018 11:10:37 PM
Craig Coleman
I agree. I like the part where she says "look on the bright side". Some people are born with the eyes to look, some people aren't, some people realize they don't and some do not. It is a natural gift. When someone suffers from mental illness because of a insecurity or secret, we shouldn't withdraw them from life as a no good and we shouldn't abuse them either. Its heartbreaking to see families broken over messed up communication.

MAY, 07, 2018 01:16:13 AM
Kimberly Ferguson
Great article. I agree with you. In my family and community my bipolar disorder made them believe that I couldn't function or succeed in life and would always need people. Well I have done good by my relationship with God and removing people who are not going in my direction. I have always believed that I would heal because I chose to reveal. My family covered it up. I recovered because I uncovered it and wrote a book about it five years ago and would share in college seven years ago and I chose to function and not carry the family dysfunction and I had a mind to achieve and persevere and I have courage to address it and not suppress it so I stand out in my family and community. I don't sweep it under the rug and I see a therapist and am open about my situation and I hope to set the example for others. But I know many people who have adult children with mental illness and they don't understand it or know how to get help and they struggle. I think classes are needed early but the majority don't get help for years and it goes untreated. My mom has a mood disorder and I inherited my bipolar disorder from her and it's hard for me to help her but I help strangers. I fuss with her about staying on her medicine and she lives alone and I have a seven year old son and I am her only child nearby but I can't help her and my siblings know that. So I just try to keep in touch with her and check on her but I need to focus on my son.

MAY, 02, 2018 01:26:41 PM
Lidia Dolliver
I live with chronic depression that is largely controlled with medication now days. Depression, bi- polar illness and boarderline disorder (terrible name for what is essentially a chemical imbalance in the brain leading to terrible, unremitting high anxiety.) I didn’t understand my illness for decades. Not even after several suicide attempts and out patient group counseling. When the medical community evolved in its understanding and developed anti-depressants, I resisted them at first, but when I started taking them, I regained access to peace and pleasure and hope. More than anything it was an enormous relief to know I had an illness and not just a deeply flawed person. That said, I still struggle to get past self-stigma. Just as RX has been a life saver for some of us, if the public was educated to kindly reach our to withdrawen people, with respect and concern, saying things like, “You seem very distant and I am concerned for you. I love you very much and am concerned you may have a chemical imbalance that has gone undiagnosed. If my concern is correct, I hope you know that it’s not your fault. I hope you don’t make any extreme decisions or give up on life until you’ve had an opportunity to be treated, in the same way that anyone with an illness seeks help.” If someone had the skill to speak to me like that, it would have saved me decades of dark, crippling despair. Whenever we see someone who is sad, dispirited and disengaged, it can’t hurt to reach out with compassion and support. So many people don’t even know they have an illness. They believe that their pain filled, inner life is “just who I am.” They have no objective understanding. And it’s only with that understanding that they can start getting the help they need. Thank you all.

APR, 30, 2018 09:51:47 PM
La Donya Milner
Wow, we have wasted a lot of time in not dealing with mental illness. I hear too often, that people should snap out of it and move on. If it were that easy, we would not need mental health clinics. What's worse is when a psychiatrist tells you that your love one is ok and they dummy down their symptoms, only to move them on to a lower level of care. Shame on the doctor's and staff that engage in such unethical practices. I say, stay involved in your loved ones care. Advocate. You have to be a voice as your love one, remember is suffering with a mental illness. Be the voice for them.

APR, 29, 2018 07:19:30 PM
Mental illness has destroyed my life. The medications have destroyed my life and twice has almost ended my life. I have lost everything dear to me even something like reading a book. I am grateful for this article and everyone who tries to help people like me. My own children have walked away from me and I try very hard to be well.

APR, 29, 2018 02:38:32 PM
Having a friend that can listen and care enough to get to know me and ride it through with me and not someone telling me what to do or saying I need medications based on a 15 minute visit. The support I have gotten from peers in NAMI Discussion Groups has many times helped me understand my illness better than doctors and therapists.

APR, 28, 2018 01:20:12 PM
katherine collins
Education is the key. There is a great need for understanding, however sadly there is still so much stigma which in turn leads to shame. My shame kept me from letting anyone know that I was suffering, when I broke my leg or when I had back trouble that was perfectly fine to share without fear. To this day there are close family and friends whom I have not shared with, simply because I don't want them to look at me like "that"

APR, 26, 2018 11:44:33 PM
Ellen Acconcia
Your article is spot on. I have been caring for my 29 year old daughter for the last fifteen years. People with mental illness are forgotten, swept under the rug. Generations have been wasted on this awful disease — people who could have lived wonderful lives and been productive citizens.

APR, 26, 2018 10:02:25 PM
Rene' Sharrock
Thank you for your awesome article.
The night before my 28 yr old son committed suicide in my garage he appeared to be quiet and withdrawn and more tired than usual. For lack of a better explanation, it seemed like he had an aura about him. It’s a long story...I just remember how his expression looked that night.

APR, 26, 2018 07:29:46 PM
Not sure why this article says “mindfulness still invokes eye-rolling” – there is no reason for that to happen. Check out the following review articles:

Gotink, R.A., et al. (2015). Standardised mindfulness-based interventions in healthcare: An overview of systematic reviews and metaanalyses of RCTs. PloS One, 10(4).

Creswell, J. D. (2017). Mindfulness interventions. Annual Review of Psychology, 68, 491–516.

APR, 26, 2018 06:41:01 PM
The fancy labels that people get assigned as a result of so-called “diagnosis” is what adds stigma to mental illnesses - we need to remember that these labels are assigned using mere check-lists. These labels not only increase stigma (someone can whisper behind the person’s back “he has X disorder…”), and could also lead to further progression of these conditions through nocebo effects (i.e., negative expectations leading to negative outcomes: opposite of placebo effects). We also need to realize that conditions like AIDS, leprosy, heart disease etc., have clear evidence of a physical health problem (or a known causative agent) and all types of treatments that work are available for them. Referring to mental illnesses as “brain diseases” also adds to stigma as this scares other people into thinking that the person is probably unpredictable and of low IQ as well. If psychiatrists need to use a label, they should simply record that label (perhaps as a code) in the patient’s medical record (code reflecting stress ratings, etc.), instead of telling the person that he has a “brain disease” with a specific name.

APR, 26, 2018 03:20:57 PM
This is so very true and so painful to try to understand what you missed

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