Stereotyping mental disorders continues the overall stigma of mental illness. I just wanted to address some common stereotypes that I’ve seen put on clients from family, friends, co-workers, teachers, etc, that may be limiting a client’s progress in therapy. Some of these stereotypes may seem extreme, while others a bit more tame, but nevertheless potentially mentally harmful.
Mental Disorder: Major Depressive Disorder
Stereotype: Everyone who is experiencing depressive symptoms has MDD (or another depressive disorder)
Breaking the stereotype: Absolutely not! There are many different types of depressive disorders, along with various features to the specific disorder. To be diagnosed with MDD (or any mental disorder), the client has to meet certain criteria identified within the DSM, which is a diagnostic manual of mental disorders. For MDD specifically, a client must be experiencing at least 5/9 primary symptoms for more than two weeks. These 9 symptoms are depressed mood, decreased interest/pleasure in activities, weight fluctuations, sleep disturbance, increased fatigue/loss of energy, psychomotor agitation, feelings of worthlessness, difficulty concentrating, and suicidal ideation. However, there are plenty of clients who report not experiencing enough of these symptoms on a day-to-day basis (for more than two weeks) to meet diagnostic criteria.
Another major aspect that is commonly overlooked is that we need to be making sure that a client’s reported symptoms are not better explained by another mental disorder, physical illness, or life event. For example, those experiencing depressive symptoms as a result of grief, abrupt life changes, or physical ailment may not meet criteria for MDD, but rather a different mental disorder (or not any!). Many symptoms resemble clinical depression, but it is not an all-inclusive illness.
Potential damage: This stereotype is limiting others from seeking help because the idea of MDD is scary for some people, which may lead to a sense of denial. But when clients do find the courage to seek help, you’d be surprised how many of them don’t actually meet diagnostic criteria for a depressive disorder. For example, untreated generalized anxiety can look quite a bit like depression after a while.
Mental Disorder: Bipolar Disorder
Stereotype: Those who have severe mood swings must be bipolar.
Breaking the stereotype: “She’s definitely Bipolar because she just freaks out over nothing.” This is by far the most common stereotype that I experience in the mental health profession, and I find it to be an insult to those struggling with Bipolar Disorder. I’ll spend some time addressing Bipolar Disorder in general, but want to put out a disclaimer that anyone can experience severe mood swings due to heightened stress, illness, or other untreated mental disorders. Other times, life can just suck for a while and they’re doing the best they can with the hand they’ve been dealt.
Bipolar Disorder used to be called Manic Depressive Disorder, which was closely tied to clinical depression. Those who struggle with Bipolar Disorder tend to deal with limited ability to regulate emotions, especially when they are in a heightened manic or depressive state.
Manic episodes may include increased energy, elevated mood, feeling energized, as well as engagement in impulsive behaviors (gambling, drug use, unsafe sexual practices), among other symptoms. When someone is in a manic state, they tend to have less control over emotional regulation (possibly due to racing thoughts and overall heightened reaction to stimuli), resulting in potential irritability, aggression, and feeling overwhelmed. Depressive episodes may include lessened energy levels, anxious thoughts, difficulty concentrating, and depressed mood, among others. Bipolar I Disorder relates more to those who have experienced an extended manic episode (and possibly the absence of a depressive episode), while Bipolar II Disorder relates more to those who experienced depressive episodes preceding or following a hypo-manic episode. Hypo-manic episodes are less severe and some clients don’t even know that they’ve experienced what would be considered to be a hypo-manic episode.
Now, think about a stressful event in your day, such as running late for work. On a scale of 1-10, how stressed would you feel? For me, I’d feel about a 7 because I hate being late for anything. Another may answer a 4 or a 2. What if I told you that you were already at a 7 in the stress scale prior to this stressful event? How would your mind and body handle another stressor? When in a depressive state, our bodies are less likely to regulate what we are experiencing at a “typical” rate, potentially resulting in impulsive outbursts or breakdowns. This is what some who struggle with Bipolar Disorder have to deal with on a daily basis, but this is only one aspect of Bipolar Disorder.
Potential damage: This stereotype not only insults those who are just trying to make it through a rough day, week, month, or life, but it also insults those who have Bipolar Disorder because it minimizes their daily struggle against their own mind. I have a handful of clients right now that have Bipolar Disorder and not one of them is similar to the other, because mental disorders display differently in each person. There is not one uniform look to a mental disorder.
For my next couple of posts, I’ll continue to address common stereotypes of mental disorders and work toward ending this overall stigma of mental illness. ❤️