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Stop calling these students mentally ill

Anxiety and depression need to be reclassified


 

Photo by Sander van der Wel on Flickr

Lately, we’ve been hearing a lot about efforts to improve the services available to students related to their psychological well-being on campuses. University presidents met for a workshop recently, and Queen’s University welcomed a new $1-million chair to study stigma.

Now, I am no mental health professional but I do know a few things about universities and have some experience with anxiety and depression.

If it were up to me, those trying to improve things on Canadian campuses would keep one crucial principle in mind: be careful how you talk about it.

First, let’s call depression and anxiety something other than “mental illness.”

I know that might sound strange and many experts may cringe, but the range of psychological burdens and hurdles is vast, and placing what can be eminently manageable problems in such a huge box with so many other conditions can have unintended negative consequences.

Case in point: the term mental illness puts students overwhelmed by workload or having trouble being away from home for the first time in the same category as deranged killers.

You’re feeling sad and tired? Well, you must be mentally ill, you know, like Jared Loughner, that college kid who shot all those people in Arizona. It’s no surprise some students don’t seek help if to seek help is to be necessarily labelled as sick.

“Mood disorder” is a little better, but even “disorder” sounds overly clinical. We don’t say a person with the flu has “a lung disorder.”

Why not “mood variation”? This is not, by the way, some lame effort to be politically correct. Political correctness tries to spare people’s feelings by making things sound better than they are (“differently abled”). In this case, I want to help people by not making it sound worse than it is.

But if it is important not to oversimplify the realities of psychological adversity, we, by the same token, should not understate that reality either. It is, of course, laudable to seek to reduce the stigma associated with troubles of the mind. But it is naive to justify and extend that thinking, as the Canadian Psychiatric Association does, by saying that mental illness is an illness like any other.

This is not a medical question: it’s a logical and linguistic one. One can point out that just as leukemia, for instance, is a disease of the blood, depression is a disease of the brain. But the brain is not like any other organ. As the seat of our thoughts, memories, and decisions, it is fundamental to who we are in a way that nothing else is. To lose the effective use of an arm is painful, and a terrible misfortune, and many, perhaps, would prefer a minor mental impairment to a major physical one. But the fact remains that a mental setback is especially difficult to understand and deal with because it goes to the essence of our identity like no physical disorder can.

Anyone who has done battle with more-than-usual anxiety, as I have, knows that when you are in the grips of a panic attack, you are, quite literally, not yourself. If you have been close to someone who has battled depression, as I have been, you know what it’s like to see someone disappear into the darkness. Am I stating the obvious by claiming that mental and physical afflictions are different? Apparently not, because the advocates keep insisting they’re the same thing.

None of this is to say that we should not take depression, anxiety, and similar mood variations seriously. Nor is it to say that we should unfairly discriminate against or denigrate those who have struggled with these challenges. Indeed, I applaud universities who are doing what they can to assist their students; no doubt, many could be doing more. But if we really want to help people, we must not oversimplify nor understate the problems. And right now there is too much of both.

Todd Pettigrew is an Associate Professor of English at Cape Breton University.


 

Stop calling these students mentally ill

  1. There is a large difference between feeling blue or infrequently dealing with bouts of anxiety and being clinically diagnosed as having depression or anxiety disorder. The requirements to receive such a clinical diagnosis are high and symptoms must persist for a sustained period (typically over three weeks); you describe a fleeting feeling of helplessness that most adults experience and is most certainly not depression. By speaking so flippantly about these mood disorders – as someone who is not a mental health professional – you are undermining the very difficult issues that these individuals face.

    Mental illness – like physical illness – can manifest itself in an acute manner or persist as a chronic condition. As such it is an umbrella term, and does not need to be redeveloped into a rigidly qualified category of general wellness. Instead, our society needs to focus on what is most important: reducing stigma so that those who suffer from mental illness feel more empowered to seek help and openly discuss their health with loved ones.

    • The term “Mental illness” is not specific enough. We do not go around saying we have “Physical illness”. There are simply too many types of mental illnesses, just as there are physical illnesses. We need to use all the specific correct terminology instead of lumping it all in one. Then we can start understanding and dealing with them.

  2. We absolutely should call it mental illness because that is what it is. The real problem is that society stigmatizes mental illness. Until we normalize it, we’ll never get over that.

    • I agree. Call it mental illness. The issue to me is the term “depression” which is confused with mood swings. When I told people I had clinical depression they thought I was sad, and related how occasionally they were sad. In my case sadness is not a symptom so the term is doubly misleading. Like rapeseed, until the name is changed we will be fighting an uphill battle.
      Jim

    • Your logic forms a perfect circle. The question is why should it be considered a mental illnes, which has a disease like connotation, when there is no evidence of an underlying biological abnormality or deficiency of depression. I think to call someone who is struggling emotionally and psychologically with something in their life “sick” or “ill” is completely stigmatizing.

  3. Clinical depression IS a mental illness. It is not simply a matter of feeling down, or blue. Real, clinical depression affects so many aspects of a person’s life, that to call it anything other than a mental illness is to minimize the severe effects it has on a person’s well-being.

  4. It is very sad and dangerous for you to write such an article without proper understanding of the field of medicine and in this case mental health. Your very own article is stigmatizing depression and anxiety by implying they are just variations of mood. The difference between various types of mental illness is often times a continuum (hence the term spectrum diseases) Some one with depression can very well have psychotic symptoms due to their depression. I hope you’ll take this opportunity to study more about mental health. As far as I know, most people these days have much better grasp of the concept than you do. Maybe you did not realize it, but you have written a very offensive and ill informed article.

  5. Unfortunately, society does stigmatize mental illness, so until we get past this, maybe a less harsh sounding term would make more sense. I actually think more people would seek help since “mood variations” doesn’t sound as bad as mental illness.

  6. I do agree that the stigma attached with “mental illness” can be problematic and often the term overcompensates for the problem, but sometimes it makes sense. For example, a few years ago I started to get depressed and extremely anxious about school, so I decided to withdrawal from some of my busier classes, but when I went to get my instructor’s signature and explained to him it was because of stress he refused! He said that as a “top student” it made sense for me to be stressed, but that was a necessary part of being a student. After he refused I went to the school health center to ask them for a “withdrawal with cause” signature, and they too said that anxiety was not enough for them to sign my withdrawal sheet and gave me some tips on dealing with it.

    A few days later I had a complete nervous breakdown and started crying and screaming in the middle of a lecture. Once the instructor got me out of the class I fainted in the hallway and required medical attention. I ended up being diagnosed with clinical depression and severe anxiety and had to get incomplete grades in all my classes, quit my job, and required constant care because my doctor was concerned about my mental state. Had my school acknowledged depression and anxiety as serious mental illness and not just an aspect of student life I might have gotten the care I needed without the public humiliation.

    • For the record, I am emphatically not saying that depression and anxiety should be ignored, dismissed, or otherwise treated lightly. That’s what I meant by “None of this is to say that we should not take depression, anxiety, and similar mood variations seriously.”

      And I’m not saying that people with anxiety and depression should not seek help; indeed, one of my main points is that calling all kinds of depression “mental illness” may well discourage some people from seeking the help they need. Of course, some forms of depression are so severe that the term “mental illness” may be apt, but that doesn’t alter my basic point about not making our categories too big. If more students get help because they can tell their friends the pills are for a mood variation rather than a mental illness, wouldn’t that be a good thing?

  7. It seems to be that not calling the issues discussed an illness may have an opposite effect than the one desired. The word ‘illness’ signals that something is serious and may require a doctor’s intervention, medication, etc. While there is a stigma on mental illness, the word illness is also what may drive people to get help.

    Calling certain mental illnesses ‘mood variations’ minimizes the seriousness of these issues. If I heard that term without knowing what it meant, I would think that it refers to something like PMS and not something for which the person suffering would require medical intervention. For a person suffering from depression, the appearance of lack of seriousness may prevent them from seeking help (or at least give them an excuse not to do so).

    Finally, in terms of stigma, let’s face it: you can call depression a “bucket full of rainbows” and that term would be stigmatized.

  8. I’m concerned with the conflation of mental illness with criminal activity that occurs in the beginning of this article and seems to reproduce the very stigmatization it criticizes. By saying that by calling these students mentally ill you put them “in the same category as deranged killers” it implies that killers are people diagnosed with mental illness and therefore that people who are mentally ill are more likely to be criminals/commit violent acts.

    • Laura, if you read the piece again you may find that I am doing the opposite of what you suggest. My point is that it is absurd to lump all people with, say, depression in with those who suffer from the most extreme forms of psychological impairment. If Norwegian killer Anders Brevik and children’s author Robert Munsch could both plausibly be said to suffer from “mental illness,” then it seems to me that the term is so broad as to be useless and, if anything, contributes to the stigma.

      Perhaps “mood variation” does go too far the other way. I’m open to suggestions. “Mood imbalance”?

  9. This article is offensive in its level of ignorance. Medically diagnosed depression and anxiety is classified as mental illness because that’s exactly what it is, and (though perhaps unfortunately) many people do not get the medical treatment they need without being assigned a clinical diagnosis. The problem isn’t with the semantics – it’s with people’s skewed perception of the nature of mental illness itself (e.g., the assumption that the killer types are the same as the depressed types, etc.). Euphemistically altering medically established terminology isn’t going to change that. What needs to change is how we talk about the complexity of the wide variety of mental illnesses in context.

  10. The author seems to reintroduce the notion of “situational depression” (or Reactive depression) vs. inborn/inherent. I know this is a dated concept. But not all that is old is bad.
    May be it is time to reconsider the mental health of the society. The other day on TV I heard that 47% of all Canadian employees have … mental health issues. Then something is really wrong with the system. And those individuals who have another point of view on mental health problem should not be considered as posing a threat, rather a challenge (I am referring to the point of view “This article is offensive in its level of ignorance”)
    IMHO

  11. If you’re a victim of war crimes perpetrated by this government, you are “mentally ill”. They’re not “mentally ill” for lying, cheating, robbing you of your health—it’s all about blaming the victim.

  12. Hi,
    If I understand correctly, Mr. Pettigrew is trying to make a point with respect to the power of language. According to him, the term ‘mood disorder’ is too all encompassing as it puts the spectrum of depressive &/or anxious people with the extreme end like dangerous out-of-control bipolars.
    In my opinion, mood disorder is an appropriate term because it is meant to be all encompassing. Mood disorders refers to a group of disorders such as depression, anxiety, bipolar I or II. It is the same as vegetables describing a group such as peas, carrots or spinach. By trying to show me that the term ‘mood disorder’ has negative connotations thereby stopping some people from getting help, you have shown to me the stigmatization of mental illness. Why do I have to play around with words to make the term more socially acceptable to those in society who choose to think that mental illness means the person is like Jack Nicholson in The Shining or that the person is really just imaging/pretending so as to get attention? The term does not need to be changed; people need to be educated! Of course, some (ignorant) people might be right. There is nothing wrong with me; it is all in my head. rofl

    • I am not going to rehash all the health and safety violations and abuses for the senile and those with selective memories. If you’re senile, they take away your driver’s license, end of story.

  13. I struggled with severe clinical depression and anxiety disorder in my last years of university and it was debilitating- more so than many physical illnesses would be. I failed several classes due to my illness’s devastating impact and almost didn’t get my degree. I did not have these illnesses because I was away from home or my workload was too much for me to handle. I had them because of a chemical imbalance, much like what causes other mental and physical illnesses.

    I cannot condone the idea that because you’re a college student some mental illness should be disregarded as just something that happens to students. One of the reasons we see this so much in college students is because the early 20s is when anxiety and depression most often hit.

    My university took my illness too lightly, and despite having documentation from doctors and psychiatrists, refused to remove the failures from my record. Now that I’m recovered I’d like to further my education, but grad schools frown on failures on a transcript in the last semesters of a degree. Because of narrow-mindedness and ideas like whats been presented in this article, some people are being hurt and not able to continue on with their lives as they’d like.

  14. I tend to agree with this article. When, many years ago, I was in first and second year I was not where I wanted to be for reasons that are irrelevant here. But there also serious constraints on being anywhere else if I wanted an education. I fought through two years of anxiety and feeling very low over this unreconcilable situation. I was NOT mentally ill, I was in a difficult situation. I pinned up “To be or not to be” over my desk in residence and fought through until I gradated. Some of the instructors who saw it thought I might be suicidal!

    If anyone had suggested I was “mentally ill” I would have slugged him. If it was a “her” I’d have laughed in her face.

    Years later in a postgraduate program I sailed through a masters degree because the same constraints were not present.

    There are certainly cases of anxiety and depression that are clinical – I’ve seen them up close, mature adults who needed drug therapy electroconvulsive shock therapy but what most students go through requires screwing up their courage to get through their life challenges. The psychiatrists and other mental health people nowadays are too quick to assess someone as mentally ill. Of course mental illness has a stigma, just as venereal disease has a stigma. Saying you are not nuts but just mentally ill is tautology. But most of depressed and anxious students aren’t in this class, I think. The person who posted here who had a nervous breakdown was simply taking on more than he/she could handle perhaps.

    In some cases life challenges are too much, perhaps involving students who should never have undertaken university education because of limitations. But I believe a lot of students have challenges that courage and determination can overcome.

    • Blacktopold, you make more sense than all the others combined , Universities are in competition for students, and admit people who never should be there.

  15. There are circumstances that make life difficult. Not for everyone, but for many people (like war, toxic job environment, exams, migration, etc). If a person feels weak in this type of situation it is not necessarily “they” have mental illness.

    Dear doctors/psychologists/psychiatrists! Do you distinguish between clients (who came for resources) and patients (who may have or may have not “chemical imbalance – whatever it means)? Do you think that not everybody who came to is ill??

  16. Dear Dr. Pettigrew,

    With all due respect, as I’m sure your intentions were good, I believe that writing this article was not a wise decision. Mental health is a tricky subject and one that still carries a great deal of stigma. I have (thankfully) never suffered from anxiety or depression myself, but I don’t think trying to minimize how life-shattering it can be for those who do suffer from it is at all helpful or fair. Calling things like depression a mental “illness” is not an exaggeration, and trying to downgrade it by suggesting that terms like “mood disorders” should be used instead is ill-advised, as anyone who is suffering should understand that it can indeed become a serious threat to their well-being if left untreated. I believe that the real solution is for us, as a society, to acknowledge that mental illness is a serious issue and that those who struggle with it should never be afraid or ashamed to seek help. Perhaps we should just try to change our attitudes towards the term “illness”, instead of trying to soften the term or sweep it under the rug, which only serves to perpetuate the problem.

    At the beginning of your article, you admit, “Now, I am no mental health professional but I do know a few things about universities and have some experience with anxiety and depression . . .” That statement alone, as you wrote it, should have suggested to you that perhaps this wasn’t a good article for you to write. Anecdotal evidence about mental illness from an English professor is not exactly authoritative. . . this is not your field, Dr. Pettigrew, and considering how delicate this subject is, I would advise you to simply apologize to those you may have offended and move on. You are, of course, entitled to your own opinion on this or any other subject, but I think it’s fair to say that sometimes those opinions are best left unshared on a public forum. Thank you.

  17. This is the most ridiculous article I’ve ever read. Period.

  18. Thanks Todd,
    Having grown up with a family member constantly suffering from panick attacks and depresssion it is difficult to get them help when they cannot see they have an issue. Often society fobs them off as just anti social.

  19. As someone surprised to be struck hard by panic attacks and serious depression in my middle years and who to survive approached it as an illness that was mental as opposed to physical (like the illneses and injuries I had suffered) I was able to seek the treatment I needed. I was ill mentally, and with relief approached it like any other illnes I’d had to manage it towards the best cure I could reasonably expect.
    Mr. Pettigrew seems to want to be helpful in some vague way and has seen and experienced suffering, but I’m not sure what his point really is. If he and I are not suffering pysically at all would he describes us as both being healthy? If one of us suffered a physical injury of really any kind, would then would that person be considered ill and require treatment?
    If the comprimise of the healthy state is mental, how does it differ from the ill health of the physical? How are they not alike, except in a wishful thinking kind of way? I would guess that where ‘an illness like any other comes from’. If you are outside a healthy state, mentally or physically, then you are in an unhealhty one. That seems obvious.
    Mr. Pettigrew, could you consider rethinking in a real way what you wrote and going at it again? The present effort seems, frankly, lazy.

  20. I agree that the term mental illness has too many prejudices associated with it but it is mostly an educational problem. I wouldn’t try to hide it with a non medical name, but personally think we should refer to it as a “Mental Disorder” or find a new name like Diabetes is a pancreatic disorder. This is the reality, well proven by science and research is ongoing:

    “Major depressive disorder is an illness with significant neurobiological consequences involving structural, functional and molecular alterations in several areas of the brain. Antidepressant pharmacotherapy is associated with restoration of the underlying physiology. Clinicians are advised to intervene with Major Depressive Disorder using an early, comprehensive treatment approach that has remission as the goal”
    Int J Clin Pract. 2007 December; 61(12): 2030–2040.
    doi: 10.1111/j.1742-1241.2007.01602.x

    So As a retired psychiatrist, who has had years of experience, and know that if people with this disorder get the proper care, they recover, and are just as normal as you or I. It does require more than the ‘magic pill’ however, to recover, but without it, it is extremely dangerous or if your lucky it takes a prolonged unnecessary time to recover. So it should be part of our general education in the schools and move well beyond the 3R’s. as well as many refresher courses for ill informed or prejudicial adults.

    Keith Quirk MD.CM, FRCP(C)

  21. First, what strikes me about your article is the use of extremes to make a point like “feeling sad and tired” with Jared Loughner or the flu with a lung disorder. I too believe in the power of language and when language is used in such an extreme way it is usually fear mongering. Politicians are good at such black and white thinking. Second, as you state yourself, you are not a medical professional and thank goodness because your experience if experience of anxiety and depression at university was very different from mine. It takes a health professional to correctly diagnose the problem and even then they make mistakes as I well know. At university, I was diagnosed with “anxiety and depression” and 25 years and 3 suicide attempts later, I was correctly diagnosed with bipolar II. Third, your saying it is a linguistic point is (sorry to say) ridiculous. The only linguistic point is the one you are trying to make which seems to me to be one that trivializes mental illness. Your whole point stigmatizes mental illness which is what we who have it are fighting against. It is time to get out of the dark ages and into the light of acceptance. Fourth, mental illness is meant to be an all encompassing term. As Cath previously said, vegetables refers to a class containing peas, carrots, radishes, etc. Mental illness refers to a class containing depressives, bipolars, schizoaffectives, etc. Fifth, it takes one to know one. The best thing that campuses can do is have support groups where students can drop in. There they can meet others with similar illnesses who might be able to get them seek the help they may so desperately need.
    Finally, what does give me a bit of relief is knowing that most students with untreated mental illness right now would be in no shape to read your article.

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