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Changing the Face of Mental Illness -- Thank You, Sarah Silverman!

A celebrity or public figure, especially a likable one, coming forward as Sarah Silverman did, and countless others in the recent past, boosts the destigmatization movement in altering people's view of mental health issues.
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A recent People Magazine article featured comedian/actress Sarah Silverman speaking candidly about her bouts with anxiety and depression. It's an honest and grounded expose of her lifelong travails with mental illness. She even opens up about taking psychotropic, anti-depressant medication, which has its own discrete and misunderstood kind of stigma. Like Beyonce, Catherine Zeta-Jones, Harrison Ford, J.K. Rowling and Lady Gaga, when high-profile individuals come out with their mental illness struggles it helps to literally change the "face" of the negatively charged, stereotyped image of mental illness that is still alive and well in our culture.

A celebrity or public figure, especially a likable one, coming forward as Sarah Silverman did, and countless others in the recent past, boosts the destigmatization movement in altering people's view of mental health issues because simply, in the public's eye, they seem normal and appear to "have it all," which is of course totally false. It has more significance because the impact of such a personal discloser from an illustrious personality figure alters from being a shameful confession or the admission of a dirty secret, to a normal, matter-of-fact expression of who they are --nothing more, nothing less. Like a sobering reality check that even superstars are afflicted with these types of conditions, plain and simple. Hence, the new face of mental illness can be one of success and talent. But since we can't all be super talented and famous, the new face of mental illness can also be one of intelligence, integrity and of an employed and productive person who contributes to society in meaningful ways.

A celebrity coming forward assists in the legitimization of mental illness by taking away the rarity of it and creating a "new normal." A new normal that will in time, organically challenge the social stigma which is characterized by detrimental attitudes and opinions that are propagated by popular misconceptions. The misconceptions come from negative portrayals in the media, misinformation, ignorance and fear. For example, attitudes that mental illness is a sign of inferiority or that only crazy neurotics are affected by it, or that people with mental illness possess a potential for unpredictable and dangerous behavior or most condescendingly, that sufferers bring it upon themselves. That last one really gets my goat! If in my young adult life I had the supreme power to manufacture the severe and crippling panic attacks I experienced, then I am not only a flipping genius but a God too. Or, I am a complete idiot for self-inducing so much suffering.

As a clinician treating mental illness, the internalized or self-perceived stigma and the shame it generates in people is the most damaging. Self-stigma also leads to depression, anxiety, low self-esteem, toxic shame and self-sabotaging behavior -- the self-defeating kind that makes people give up and settle for a compromised life devoid of hope. And naturally, despite treatment, the self-perceived stigma leads to substandard treatment outcomes and even more disturbingly, fewer sufferers reaching out for help due to fear of judgment and subsequent discrimination.

According to a 2014 report by the Congressional Research Service (CRS), about 26 percent of adults in the U.S. reported suffering from a mental illness. The numbers of other people that suffer mental illness who don't come forward is unknown. That's very unsettling.

But more interestingly, the CDC reported in 2014 that poor mental health treatments result in an increase in other health problems and a bleaker outlook for the future. People in general are at greater risk for undiagnosed and untreated mental illness. Risk factors are, potential for suicide, substance abuse, legal issues and future adult psychopathology. So in trying to keep their condition secret thinking that it helps make them safer, they are only making it worse. Perhaps we as a society are to blame for that.

It's unfortunate that for now, one of the only ways the message gets across to people is when a popular luminary discloses their mental illness. Perhaps they are a bit star-struck and the halo effect takes over where celebrities are so pedestalized that they cannot ever be seen in a bad light. Suddenly, when a celeb opens up like Sarah Silverman did, the illness they have isn't so weird and loathsome after all.

Anyone who reads my blogs knows that I am a big supporter of many social issues in this country, but the one that I am most passionate about is destigmatizing mental illness conditions and disorders. Still to this day, although there have been some significant changes in attempting to put mental health issues at an even plain with medical illness, we are still far behind and have lots of work to do.

It's still grievous that the stigmatization of say depression, severe anxiety, addictions, etc., is perpetuated because there is a lack in numbers in the public eye. The public sees sanity in numbers, meaning that for most people, mental illness is uncommon, and people can't identify well with things they know little about. To them, it's different and if it's different they can't always understand it.

For example, think of how many millions of people believe in miracles, divine intervention, having personal conversations with their God, etc. Because so many believe that, it's not only normal but perhaps it's true (how can it not be true when so many believe that it is?). It's a blameless overvaluing of a socially accepting thought or a belief basically because everyone else believes it.

But imagine if the tables were turned and only a handful of people, say a few hundred thousand believed in the supernatural, divine miracles, etc., we would see them as psychotic, unstable people who are out of touch with reality and who are of unsound mind. Frankly, I personally only believe what I see (admittedly, that statement in itself is very narrow minded to the possibility of things I can't see) and someone who claims to see angels and believes that people rise from the dead is perhaps siding with the numbers and believing simply what someone told them or what they read in a book.

Sanity in numbers means people don't have to question it because everyone else believes it and since it gives them comfort, they believe it wholeheartedly despite how truly crazy it sounds. Then their minds shut down and that becomes part of the infrastructure of their world view: A closed system of beliefs lacking in exposure and openness to other frames of reference just because there are so many others that believe it. And, despite the presence of evidence, science, research etc., it's quite mind-boggling that it still continues. Call it what you want -- blind faith, anti-intellectualism, ignorance, dread, whatever it is -- big numbers don't lie. Remember, "You can lead a person to knowledge but you can't make them think."

However, sanity in numbers for a "new normal" of mental illness can only come with more voices speaking up. The kinds of voices that come from people who live fairly normal and productive lives despite their condition.

Thank you, Sarah Silverman!


If you -- or someone you know -- need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.