TThere is no doubt that the public attitude towards mental health has turned a corner here. Consider the number of public figures who have opened up about their struggles, from Robbie Williams and Lady Gaga to Baroness Davidson.
According to an analysis of British newspapers, between 2008 and 2016, the number of articles stigmatizing mental illness roughly halved, while those challenging the stigma doubled over the same period. And it seems to have a positive impact on everyday experiences of prejudice – people with mental illness say they are less discriminated against by family, friends and colleagues now than they were a few years ago.
Despite this, some myths about mental illness, including false claims about the effectiveness of treatment, are still widespread. Here are six of the most common beliefs and the truth behind them.
Mental illness is overdiagnosed
Let’s start with the idea that people often mistake everyday pain for clinical illness. The claim is a favorite of television personalities and newspaper columnists, who argue that the increased focus on mental health at times leads people to turn to medical interventions and lower their self-esteem rather than solving problems in their lives.
In fact, there is very little hard evidence that overdiagnosis is as serious a problem as some have claimed. For example, depression surveys in Western countries have failed to show a large increase in diagnoses as people jump to “mental health”. Johan ‘Hans’ Ormel, a professor at the University of Groningen in the Netherlands, said: ‘The evidence points to persistence. He says doctors often miss real cases, like misdiagnosing a person experiencing a temporary problem.
Time is a cure
In connection with the claim that doctors are treating everyday distress, there is a suggestion that many people who think they are depressed should show more resilience and wait for time to heal their suffering. If they only experience temporary pain, should the problem go away on its own?
To find out if this was indeed the case, Australian researchers looked at data from 16 clinical trials in which a control group of patients were put on a ‘waiting list’ before treatment. They found that only one in eight of these patients went into remission while waiting for therapy, while the rest continued to show symptoms over a three-month period.
Antidepressants don’t work
It’s not just the diagnostic process that inspires medical legends; Treatments used to help patients are often the subject of misinformation.
A common belief is that a common class of antidepressant medications, called SSRIs (selective serotonin reuptake inhibitors), are ineffective and work no better than placebos. This idea has recently received widespread attention after an article was published that raised questions about the proposed mechanism of these pills.
SSRIs, including Prozac, are thought to address “chemical imbalances” in the brain by correcting levels of serotonin, a neurotransmitter believed to be involved in mood regulation, among other functions. However, the latest paper examines the evidence to date and concludes that there is no clear link between serotonin levels and depression.
But there are many other ways in which they can help alleviate symptoms — reducing inflammation, for example, is another potential contributor to depression. Importantly, a recent meta-analysis lancet, taking into account several clinical trials, confirmed that SSRIs are effective in relieving depression. Although they don’t work for everyone, they have about a 50% higher response rate than placebo pills. According to Professor Catherine Lewis of King’s College London and Professor Andrew M Mackintosh of the University of Edinburgh, the benefit is now “clinically beyond doubt”.
“Happy pills” just numb people’s emotions
Other myths are about side effects. You will see many articles claiming that anti-depressant pills, for example, “stop” people’s emotions. There’s a seemingly good basis for this idea: Many patients worry that their medications will dull both the highs and lows of life, causing them to lose their senses.
But until recently, there have been few studies investigating the causes of emotional blackout, and now it seems that feeling overwhelmed may be a residual symptom of depression. This makes sense: depression is often accompanied by apathy and a lack of pleasure. SSRIs have eliminated the most prominent feelings of hopelessness – but they do not necessarily say that they increase positive emotions and motivation, Oxford University professor Guy Goodwin, who recently conducted a study: “Emotional vagueness is real, but it is not caused by drugs.
Mental illness makes people creative
From Virginia Woolf to Kanye West, the idea that mental anguish is the source of artistic genius has been the most enduring myth. James C. Kaufman, a professor at the University of Connecticut, says any evidence for a link between creativity and mental illness is very weak.
For example, “historiometric” analyzes complement the biographies of prominent artists. As these studies suggest that mental illness is common in creative individuals, any post hoc diagnoses based on text should be viewed with great caution. “They’re not super objective,” Kaufman says. “Few creative researchers believe there is a strong connection.” And the idea that mental suffering inspires great art certainly shouldn’t be a reason to avoid treating serious illnesses, he says.
Schizophrenia cannot be cured
Despite changes in attitudes towards other mental illnesses, schizophrenia still carries a huge stigma, says Marjorie Wallace, founder and chief executive of mental health charity SANE. “Schizophrenia is still the ‘forgotten illness’ because it has been squeezed out of all the anti-stigma campaigns that focus on stress, depression and anxiety.” This means that most people only have a vague understanding of the condition, despite a lifetime prevalence of around 1.5% in the UK.
One big misconception is that schizophrenia is simply “untreatable.” With appropriate medication and talk therapies, 45% of people with schizophrenia go into remission after one or more psychotic episodes, and 35% show a mixed pattern of remission and relapse. The belief that there is no chance of recovery can be a source of great despair for people with this disease and their families. (Campaigner and film-maker Johnny Benjamin is famous for making the diagnosis feel like a life sentence.)
In general, earlier interventions are more effective. But a chronic lack of resources in health care means many people with schizophrenia don’t get help in the early stages of a crisis, Wallace says, which reduces their chances of recovery. They may be removed from hospitals or psychiatric facilities and are often police officers who work with the patient. In such cases, the worsening of their condition only adds to the idea that it is not treatable, but it would be much better if the person had access to treatment earlier.
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