Behind the diagnosis

Behind the diagnosis

Looking Beyond Mental Illness Stereotypes

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Written By: Kate Couch

Associate Editor in Command: Laura Waltosz

*[Disclaimer] The names of people interviewed in this article have been changed for privacy reasons.

I drove up to the block of buildings that the GPS had said was the office, after parking, I walked up to a large, newer building and went inside. After seeing people in lab coats and latex gloves I instantly realized I must be in the wrong place. I walk around to the building next door and see a small sign on the door, ‘’Bend Family Therapy,’’ that was easy to find I thought to myself. The trouble finding the office and facility buildings began to build as a common theme when interviewing therapists. Their offices were off the roads tucked away, often within clusters of other offices. There were no large signs, you have to know what you’re looking for if you want to find it. I opened the door to be nearly instantly greeted by a dog who I assumed to be a therapy dog. The receptionist a few minutes later told me to have a seat. Bend Family Therapy is a family mental health services clinic, which treats and assists local families, individuals, couples, and children struggling with mental illness. 

As I sat down, I instantly noticed that I couldn't really hear myself think. As I looked around to hear what was making that noise, my attention was drawn to a little white circle sitting on the floor against the wall and two more further down the hall. Because of my experience with babysitting, I instantly recognized the machine; a white noise maker pushing out loud yet soft air. After processing this I realized that I couldn't really hear anything, the noise machines kept the conversation and meetings held behind closed doors private even to others receiving help. The whole topic of mental health is very quiet but society is going into a new stage of talking about mental health. Be this as it may the community as a whole is still extremely private and it's left up to the patient on how much they want to share. 

The Doctor Will Be Right With You

The waiting room reminds me of a yuppie dental office minus the black and whites of upper-crust white people with perfect teeth. The artwork was the typical abstract trees printed on canvas from your local ROSS, a water cooler in the corner, and a coffee table with people magazines. After waiting for a few minutes, I began to feel myself sink into the couch that had no support in the center. Feeling like I was a patient waiting to spill my problems out. Feeling that relief of telling someone else your pain. 

When I was greeted by the therapist and welcomed into the room I wasn't surprised about what I saw. For once maybe the stereotypes were right. There was a gray couch with two purple pillows. Next to the couch were two chairs and a small side table. To the right, a chair, tucked beneath the desk, pictures of her family and a large computer placed on top. The room was the perfect temperature with low light lamps sporadically placed as wallflowers. Though the inanimate objects gave the appearance of security there lack of eyes didn't stop me from feeling as though I was being watched. Meticulously obverting my eyes from taking more than a momentary glance. She talked slowly, comfortingly as if her words were slow-motion arrows hitting a target you couldn't see. Her tone was overtly meticulous to the point that her inflections read with little emotion. She was truly an unbiased listener even though she was the one doing most of the talking. After answering my questions I thanked her. To my surprise, she thanked me too, as if she was happy I was doing this project. The community didn't quite differ from facility to facility. The interviews following were composed similarly- their offices looking like twilight zone versions of themselves. 

Visiting Deschutes Behavioral Health's extreme cases, their building and offices looked and felt the same as some of the others I had visited. With the exception of automatic locking doors every 10 ft for safety. When dealing with patients that can be a harm to themselves and others safety is the number one priority. In fact, both therapists whom we’ll call Karyn Smith and Carol Witman are first reporters.  This means that if any of their patients mention harming others they are required to report this. Patient confidentiality laws are overridden and the therapist must first contact the person in danger, then the authorities. 

Behind Closed Doors

Carol Whitman, an adolescent therapist and my own therapist explained to me that she commonly comes across anxiety, ADHD, and autism. She works with her patients to help them live normal lives and overcome daily struggles caused by their mental illnesses. Whitman doesn't just consult adolescents as she also deals with couples and families. But just because she works with a lot of mental illness does not mean she only works with people with mental illness. ‘’ Who needs therapy? Well… anyone who wants to overcome a struggle, get something off their chest or find answers, therapy isn't a thing for crazy people, it is a way to take control of your life’’ (Whitman). She explained how 15 years ago going to therapy was a ‘’hush hush’’ thing that was embarrassing but now more and more people are realizing that they need it. When it comes to medication Whitman says that people who take medication almost always have therapy along with it. However, people who have therapy don't always take medication. Medication in general can be scary for some people to take. Frankie Bennett who struggles with OCD commented on this, ‘’I don't like something like that having control over me.’’ It also has been disproven in some studies. In James Lake’s (MD) scholarly article, ‘’Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care.’’ He discusses this, ‘’Many individuals diagnosed with bipolar disorder, major depressive disorder, and schizophrenia depend on medications to function and be productive members of society. However, after decades of research and billions of dollars of industry funding, the evidence supporting pharmacologic treatments of major depressive disorder, bipolar disorder, and other psychiatric disorders is not compelling.’’ Medication though, more advanced compared to previous decades still isn't where it needs to be. Oftentimes exercise, healthy eating, and therapy are the best routes. Therapist Kelly Ram says she always recommends healthy eating and exercise when the case inst extreme. When it is patients don't have that many options. If medications fails them some end up just giving up, it is heartbreaking. 

People are often incognizant of how common mental illness is. In fact, EVERY SINGLE person I talk to mentioned to me something along the lines of ‘’mental illness is common and they live similar lives to you.’’ They really wanted to imprint this idea in the public's mind. It was surprising to me to hear so many people say that. It made me think of how I view or (viewed before this) mental illness. Were they these crazy people on the street, banging their heads on a wall while whispering stop talking to me Steve over and over? Or were they the barista who makes your coffee every morning, your landlord who seems to always be stressed out? What people picture in their minds as mental illness is crazy what they don't picture is normal but hurting. 

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Getting Help

One of the saddest things to see in a lifetime is a friend or family member struggling and them not willing or ready to get help. You are stuck there rendered helpless watching the very person you love struggle with something you could never fully understand. But be that as it may, the saying stands true, people have to want help. Many of the teens that I talked to had people recommend to their parents that they see a therapist. When it comes to minors there is a grey area as far as attending therapy. But oftentimes school counselors, pediatricians, and social workers will recommend it to adolescents and their parents. This process can be lengthy. ‘’ Well, my school counselor recommended I see a therapist and that was 3 years ago and I just started going 5 months ago’’ (Char Locksley). This may because of reluctance with the child or just how things pan out. Regardless, the patient has to want to participate for any progress to be made. ‘’To make any progress with teens and children patients the child has to be ready to talk and open up’’ (Suzan G.).  If the patient doesn't open up they won't get anywhere. Experiencing this in my own therapy I found that when I was younger I would pout and not tell my therapist things; but now much older I realize the benefits of therapy, be that in a private or group setting. Like Whitman said anyone and everyone could use therapy. It's 30-120 minutes out of your week to sit down destress, self-reflect, open up, and not be shamed. 

Finding a therapist and getting help is easy and private but not as private as used to be.  ‘’When I was a kid, going to therapy was for crazy people. If you went to therapy there was something really wrong ‘’ (Witman). Now though in the twenty-first century mental illness has been brought to a new light. With things like Mental Awareness Month (May). As well as therapy and mental illness stigmas being rendered false. More and more people are embracing the importance of understanding mental illness. ‘’ People think that if you can't see it (mental illness) it's not there’’(Karyn Smith). She was so right. As she said this, I remember thinking about how I had fallen victim to this kind of mindset before. 

Mental Illness has a stereotype of being a rare and often times a fake thing, just because it doesn't normally show symptoms on the outside. ‘’In reality, almost everyone will struggle with depression or anxiety in their life, which are both very real and manageable diseases’’(Dr. Kelly Ram). We forget how common mental illness is. Sometimes we ignore serious problems in our life and make them into excuses like, ‘’temporary stress’’ or ‘’I'm just tired.’’ When in reality they can mean much more. We go go go until we are forced to stop. If you ignore your mental health you will be forced to stop for your actual health, as they often go hand in hand when not treated.

By people being willing to open up and talk about mental health we are finally opening a new chapter of personal health awareness. Which is something we need considering that suicide in America is the 10th leading cause of death, according to the American Foundation of Suicide Prevention. Also according to other mixed sources, the suicide rate has gone up around 25% since 1999. This graph from AFSP (upper right) shows suicide rates in the U.S. and then in Oregon (Oregon in teal on the top). Suicide is something we take too lightly and prevention starts with mental health care, which everybody needs. 

 In their shoes

Close your eyes, imagine you have just woken up in the morning. You walk to your bathroom and get out your toiletries. You do not just pull them randomly you have a specific order, toothpaste, hairbrush, toothbrush, lotion, contacts. You use your items then place them back in the drawer contacts, lotion, toothbrush, hairbrush, toothpaste, and then close the drawer. You get dressed, if it does not feel right you must start over and do it again until the clothes feel right. ‘’There is not much more to describe it, I just know when it feels wrong.’’ (Bennett). Now you are about to leave, you grab your backpack and you are supposed to put it on your right shoulder then left shoulder, but you mess up. You are late so you run out the door. ‘’This is the start to a bad day’’ (Bennett). This gives you a sinking feeling in your stomach. Later that day you step on a crack, forget to lock the doors, and turn the lights off wrong. These things lead to excessive worry, panic attacks, and other symptoms. 

This is daily life for, Frankie Bennett, who has been diagnosed with OCD. Obsessive-Compulsive Disorder is defined as according to the National Institute of Mental Health,’’ a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.’’ It's a disease we take so lightly yet can be so crippling. Mental illnesses can be isolating. It can also cause the opposite and sometimes worse result, you can be put on a pedestal for people to coddle, misunderstand, mock, or completely and purposely ignore. Things we all will feel in our lifetime, that can be run-of-the-mill normality for someone struggling with mental illness. ‘’Growing up my parents thought I was crazy. I would do weird things none of us could explain’’(Bennett) These words were hard to hear coming from my best friend. I had known about her situation before but hearing about it like this made my heart ache with empathy. When a friend or family member opens up to you about something like this it's hard to find the right balance of help vs. patronize. In this interview I had to sit back and say as little as possible, knowing that whatever I did say wouldn't take away her pain. 

Bennett was not officially diagnosed with OCD until age 13, now 16 she explained how getting a diagnosis was freeing. ‘’Knowing the why, helped me realize that my compulsions and thoughts were not out of a dark crazy place in my mind, but rather a chemical imbalance, ‘’I'm not crazy I thought to myself’’.’’ Though it may seem strange to people who don't understand, getting a diagnosis can be fully understanding why your struggling in certain areas of life. Some people don’t experience this because of being diagnosed at a young age like Gracie Bernard who has ADHD. ‘’ It didn't mean much to me, in fact, I thought it was normal like everyone had it. It wasn't until I found out I was different that it sank in’’ (Bernard). This resonated with me, growing up I thought everyone was just like me. There was a time when our family had to go to the food bank. I didn't become embarrassed about this till I realized that not everyone couldn't afford food. As a child you think that you and your family are normal, that goes for mental illness too. 

Every mental illness comes with stereotypes or misconceptions. What some people don't realize is how much stereotypes can affect the people that struggle with mental illness. ‘’People think it's (ODC) all about cleanliness and organization’’ (Bennett). Bennett says there are few things she hates more than people saying ‘’oh I have OCD I like to keep my room clean,’’ or random ODC stuff she sees online. ‘’OCD does take many forms and can often include checking, and organization and washing your hands; but when people take that to think that it's just this thing everyone can have, or it's not a real thing people struggle with, they are just wrong’’ (Bennett). ‘’People think that depression means you’re just sad or down in the dumps (rolling her eyes) ‘’just be happy’’ oh thanks I have never thought of that!’’ (Locksley) When we become familiar with what mental illness actually looks like in society we can better suit ourselves to understand the signs of someone struggling and to help them in the best way possible. But to above all else treat them like they’re normal as long as that is with respect. Society really does affect mental health. Dr. Ronald Manderscheid in his peer-reviewed article, ‘’Evolving Definitions of Mental Illness and Wellness’’

 says  ‘’Mental health and mental illnesses can both cause and be influenced by positive or negative social determinants of health.’’ We disregard how much media, society, and people affect us. It seems in today's day and age we lack general respect for our mankind, whether it's in mental health, race, politics, etc. Just because I don't agree with you doesn't mean you don't deserve my respect. 

Underneath the Bustle

Media, Netflix, movies, TV shows, Buzzfeed and, Disney are all part of the overwhelming world of popular culture but do they accurately represent instances in real life? When it comes to mental health there's no better time to talk about it than now. Mental Illness is having its day in the sun becoming a more talked about and widely accepted subject nationwide. Be this as it may stereotype are still the main way we display characters in theater and media. Taking the movie Rain Man for example from 1988. It may have won an Academy Award for Best Music Score but that doesn't mean you should overlook the extreme stereotypes it uses when explaining life with autism. 

Even with famous people we take things and distort them to be what they are not. Amanda Bynes who was struggling with drug addiction and depression was ridiculed in the media. Being called ‘’insane and on the run’’ and many other awful names. Others like the Kardashians, Britney Spears, and Kelly Ripa were shamed in the media for things we don't even know they were going through because we are feed lies about their lives. 

The TV series, Crazy Ex-Girlfriend for example does a good job of showing what it's like to live with mental illness. [Spoiler Alert] The main character, Rebecca Bunch, has by the 4th season of the series been diagnosed with Bipolar (a very difficult disease to diagnose according to Whitman, Smith, and Ram). Throughout the show, you get to see her struggle with this and how it affects her life. When I first watched the show she came across as pure crazy in the time leading up to her diagnosis and recovery of attempted suicide. She destroys everything good in her life and pushes away family and friends. In an article by Sydney Bucksbaum from Bustle, ‘Crazy Ex-Girlfriend’ Finally Diagnosed Rebecca And Nailed The Reality Of Living With Mental Illness. She says, ‘’When someone is living with a mental illness, it doesn't just magically go away once you find the right "label" for it. Living with a mental illness is just that: learning how to actually live with it and manage it as best as you can. It was extremely impressive how the episode touched on all the ways people tend to cope with mental health issues, both suffering from them or watching someone in your life suffer from them.’’ Crazy Ex-Girlfriend doesn't just label and leave, they show the real struggles that people go through every day. 

It's such a relatable show even if you don't have a mental illness. Even though she comes across as crazy that's the point that what she is going through. After, attempting to take her life for the 2nd or 3rd time she finally gets the proper help she needed. That's what this show displays-reality- and I applaud them for making such bold choices. There is also an original song and dance number in almost every episode so they’re doing more than just one thing right. 

It's not just Crazy Ex-Girlfriend that displays accuracy in mental health in pop culture. Silver Linings Playbook, Wild, Perks of Being a Wallflower, Sherlock, even Disney's Frozen. These books, movies, and shows can't get everything 100 percent right but nothing can because if there is anything I have learned from this project it is that every symptom, cure and, cause varies from case to case. 

Looking Back

‘’Life is about perspective and how you look at something... ultimately, you have to zoom out.’’ -Whitney Wolfe Herd. This project gave me the opportunity to zoom out on what my view was on mental illness. Even though I see a therapist for stress and have friends and family who struggle with mental illness there are things I learned about the community that shocked me. Like how private it was; seeing sound machines, name change requests, and having difficulty getting interviews showed me that this community is quieter and more reserved than I thought. Another surprising fact I learned was how most everyone will experience depression and anxiety in their lives. I went into this, honestly thinking depression was rare and most people who ‘’had it’’ were fakers. To learn how I was wrong was humbling in a way I didn't know I needed. 

I gained a respect for these people and their community deeper than I had before. Telling if someone has a mental illness can be like telling if someone is right or left-handed. That's what makes it so hard to integrate mental illness properly into society. If we can't see it we want to believe it is not there. That mom that can't come to work some days because her depression won't let her get out of bed. The boy who is being ridiculed for his grades when in reality he just can't sit still long enough to learn. Believing mental illness isn't there because we can’t see it all the time, can seem like an easy and simple way of thinking. But life, mental health, and emotion are not simple so why should the way we think about them be. It's a juvenile habit we need to break, that I will counting trying to break, the question is will you? 

If you or someone you know is having thoughts of suicide please call the national suicide prevention hotline at 1(800) 273-8255

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Works Cited

Bennett, Frankie. “Interview, TEEN #1.” 8 May 2019. 

Bernard, Gracie. “Interview, TEEN #3.” 30 May 2019. 

Bucksbaum, Sydney. “'Crazy Ex-Girlfriend' Finally Diagnosed Rebecca, And Nailed The Reality Of Living With Mental Illness.” Bustle, Bustle, 7 May 2019, www.bustle.com/p/crazy-ex-girlfriend-finally-diagnosed-rebecca-nailed-the-reality-of-living-with-mental-illness-5495597. 

G, Suzan. “Interview #1.” 15 May 2019. 

Manderscheid, Ronald W et al. “Evolving definitions of mental illness and wellness.” Preventing chronic disease vol. 7,1 (): A19.

Lake, James, and Mason Spain Turner. “Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care.” The Permanente journal vol. 21 (): 17-024. doi:10.7812/TPP/17-024

Locksley, Char. “Interview, TEEN #2.” 30 May 2019. 

“NIMH » Home.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/index.shtml. 

Ram, Kelly. “Interview #4.” 30 May 2019. 

Smith, Karyn. “Interview #3.” 28 May 2019. 

“Suicide Statistics.” AFSP, 16 Apr. 2019, afsp.org/about-suicide/suicide-statistics/. 

“Whitney Wolfe Herd Quotes.” BrainyQuote, Xplore, www.brainyquote.com/quotes/whitney_wolfe_herd_837228?src=t_perspective. 

Witman, Carol. “Interview #2.” 23 May 2019.