By Dr. Paul Latimer
Every day I talk with people from all walks of life diagnosed with a psychiatric illness – and every day in the course of these conversations, I hear about the difficulty many have in accepting their diagnosis.
Difficulty accepting a diagnosis can show itself in many ways. Many feel angry they have to bear the burden of living with a psychiatric disorder – or they find it difficult to believe even when they know it is true. Still others express their inability to accept a diagnosis by denying they are ill at all.
Unfortunately, difficulty accepting the reality of mental illness can play a significant role in a patient’s decisions. Often people withdraw from treatment, stop their medications or react by attacking psychiatry or other people with mental illness.
In reality, we all have to accept things we don’t like. I think almost everyone has some characteristics they would prefer to change, but over which they have no control. Height, gender, personality characteristics, intelligence, talents or lack thereof are only a few examples in a very long list of qualities we must live with.
Of course, psychiatric illness is not the only kind of health problem people have trouble accepting. Those with other diseases can also experience anger, fear, regret and hopelessness when faced with diagnosis.
However, when I point this out to people in my office, they often say they would find it much easier to accept a diagnosis of cancer. Many feel at least in that case, they could discuss it openly with others and would likely receive a sympathetic and caring response.
In the case of a psychiatric diagnosis, people do not usually feel it is possible or wise to share with others. When the problem is shared, they are often met with silence, avoidance, ridicule or condescending remarks about showing more discipline or changing their behaviour to eliminate the problem. In other words, people are often held responsible for their illness and are therefore considered unworthy of support.
Very often it is only a person’s closest confidants who can be told – a spouse, parent or trusted loved one. Even family members are often unsupportive and are kept in the dark.
Sometimes people have unrealistic or excessive fears about how others will respond to their illness, but all too often fears are confirmed when people do finally have the courage to talk or if others become aware unintentionally.
A common result of keeping something like a mental illness secret is paranoia. Many begin to feel like everyone knows the secret or believe information would be used against them in a marital breakup, custody battle or employment situation.
Although it can be a relief to finally share with someone, there are often unfortunate consequences. For example, it is very common for people in the midst of separation and custody battles to try to use their partner’s mental illness against them. One partner discovers the other is seeing a psychiatrist and believes this is enough to make the other seem an unfit parent in court.
Fortunately, in these instances, I can honestly reassure people that this will not be sufficient basis for making a legal custody decision. With some other fears, I am not able to be so certain.
All too often, I do find parents, partners and other friends and family offering unsolicited advice and recommendations, which are often based on nothing more than ignorance, myth, prejudice and superstition. This can make it all the more difficult for an individual to accept a diagnosis.
Although it is helpful when celebrities come forward to talk about their mental illness, it is not enough. It can offer some hope to learn that people with mental illness are still capable of great accomplishments and courage. Unfortunately, our society is still at a very primitive stage of acceptance of mental illness even though it touches every one of us in some way.
We must all continue to work against the prevailing stigma and false information floating around about mental illness and the people who live with it.