Mental illness is biologically based: It’s time to end the stigma

By Kimberly Blaker, June 2020 Issue.

Nearly one in five American adults experience mental illness in any given year, according to the National Institute of Mental Health — and one in 25 experience a serious mental illness (SMI). Those with an SMI consist primarily of schizophrenia, schizoaffective disorder, bipolar disorder, and severe major depression.

Unfortunately, people with mental illness experience a high degree of stigma. They often experience discrimination in the workplace and their personal lives from those who see someone with a mental illness as odd or flawed. This often results from a misunderstanding of mental illness and not recognizing that it’s a medical condition.

In recent decades, the stigma surrounding mental illness has improved slightly. Yet it persists. Part of the problem lies in that it falls under the field of psychology, the study of human ‘behavior.’ Much of society doesn’t understand mental illness often has biological and genetic roots. So people often see mental illness as indicative of personality flaws or learned behavior and think someone with mental illness should be able to just ‘snap out of it.’ 

Many experts and advocates recognize this problem and have called for biologically-based brain diseases to be reclassified into more appropriate fields of medicine such as neurology. This move would go a long way toward reducing stigma. Reclassification would also help to ensure those with brain illnesses can get insurance coverage and adequate treatment.

In the meantime, what can be done to reduce stigma? Educating society on what mental illness is and is not, is vital. When people with a mental illness brave coming out and telling their personal stories, more people hear the message. Celebrities sharing their own personal experience has been particularly helpful. The public is often more receptive when admired stars share their trials and tribulations.

The following illnesses qualify as serious mental illness. You’ll also discover some celebrities who’ve been diagnosed with each.

Major depressive disorder (MDD):

In any given year, 6.7% of the population will experience MDD. A smaller percentage suffers from severe MDD. Unlike the occasional sadness or blues many people experience, MDD is a persistently low mood that interrupts daily living. Symptoms include changes in appetite and sleep, lack of energy, difficulty concentrating, feelings of hopelessness and worthlessness, loss of interest or pleasure in usual activities, ruminations about death, suicide attempts, and in severe cases, psychosis.

The exact cause of MDD is unknown. What is known, though, is that a variety of factors can contribute to the disorder. These include biological changes in the brain, genetics, hormones, and brain chemistry. 

Some people with MDD might experience a single bout. Yet for others, it’s chronic. Fortunately, antidepressants are effective for most people. Though some are treatment-resistant leading to long-term disability. 

Ashley Judd, Owen Wilson, Gwyneth Paltrow, Heath Ledger, and Winona Ryder are among the many celebrities who’ve battled major depressive disorder.

Bipolar disorder (BD):

This disorder, affecting 2.6% of the population, is marked by emotional extremes ranging from depressive symptoms, as described above, to mania or hypomania. During manic episodes, sufferers experience a decreased need for sleep, extremely elevated mood, and increased energy or agitation. They’re also easily distracted, may have racing thoughts, and take foolish risks. For some people with BD, delusions, and hallucinations accompany mania.

Though the exact cause of bipolar is unknown, it’s biological and often genetic.

Bipolar is highly treatable, though some people experience treatment resistance. Also, during manic episodes, people with BD are typically unable to recognize their illness. Left untreated, it can be a very debilitating disease.

Some celebrities known to have bipolar disorder are Demi Lovato, Charlie Sheen, Mel Gibson, Carrie Fisher, and Sinead O’Connor.

Schizophrenia and schizoaffective disorder:

These two diseases affect 1.2%  and .3% of the population, respectively. Schizophrenia is the most serious mental illness of all. It’s marked by symptoms of psychosis, which are paranoia, delusions, and hallucinations.  Disorganized thinking, speech, or motor movement is also present. What fewer people are familiar with is what’s known as ‘negative symptoms.’ These prevent a person with schizophrenia from functioning. Those with schizophrenia often have poor hygiene, withdraw socially, and have a symptom known as avolition, which is a decrease in motivation. 

Despite new and improved medications for this disease, only one-third of sufferers can lead a relatively functional life. Another one-third is treatment-resistant, with the final third receiving a degree of relief. As a result, two-thirds of those with schizophrenia are dependent, or often homeless or housed in America’s jails and prisons — known as today’s new mental health institutions.

Schizoaffective disorder is marked by features of both bipolar disorder and schizophrenia.

While the cause of these two disorders is unknown, researchers believe genetics, biology, and environmental factors combined ultimately contribute to these brain diseases.

Finding celebrities with these two diseases is rare because schizophrenia and schizoaffective disorder typically strike during the late teens to the early 20s resulting in moderate to severe disability. However, John Nash, Lionel Aldridge, Calen Pick (nephew of Glenn Close), and Eduard Einstein (son of Albert Einstein), all suffer, or suffered, from schizophrenia.

Obsessive compulsive disorder (OCD): This perplexing disorder, which affects 1% of the population, is marked by obsessions and compulsions. Obsessions are most commonly seen in the form of fear of contamination or harm to self or others, excessive concern with order or bodily symptoms, or intrusive religious thoughts. In turn, those afflicted with OCD act out compulsions to alleviate their fears or thoughts. This is done through repeated acts of checking, organizing, washing, or senseless acts of tapping, counting, or repeating words.

Medication combined with therapy helps treat OCD, though the prognosis is better for those with milder symptoms. Many people with this disorder experience severe debilitation.

The cause of OCD is understood to be a combination of genetics, biology, and environmental factors.

David Beckham, Marc Summers, Howie Mandel, and Fiona Apple are known to suffer from OCD.

Panic disorder:
One in 10 adults experiences a panic attack every year. Panic disorder, however, affects only one in 33 people. With this disorder, people experience sudden and repeated bouts of extreme fear that lasts at least several minutes, if not longer. The symptoms include shortness of breath, racing heart, trembling, weakness, dizziness, chest pain, tingling or numbing of hands, stomach pain, and nausea. Sufferers may also experience fear of dying, going crazy, being out of control, or impending doom. Panic disorder often results in the avoidance of things or places where attacks have previously taken place.

Panic disorder is highly treatable with a combination of medication and psychotherapy. It’s believed to be biological and genetic in nature.

It’s unclear whether the following celebrities have been diagnosed with panic disorder. Still, they’re known for experiencing panic attacks: Johnny Depp, Princess Diana, John Mayer, and Emma Stone.

Anorexia or bulimia disorder:
These two eating disorders combined affect one in 40 Americans, mostly women, and share many of the same symptoms. These include the absence of periods, slow heart rate, swelling, dizziness, constipation, hypotension, hair loss, and more.

Treatment consists of medical care, nutritional counseling, psychotherapy, and medication. Prognosis varies by the particular illness, among other factors. Still, a significant percentage do not reach full recovery, sometimes resulting in death.

It’s believed genetics combined with psychological and sociological factors contribute to eating disorders.

Sadie Robertson, Gabourey Sidibe, Zayn Malik, and Beverly Johnson have all struggled with eating disorders.

Autism spectrum disorders:
These disorders affect one in 68 children. Symptoms include repetitive or unusual behaviors, intense interest in particular topics, making little eye contact, facial expressions and gestures that don’t match what’s said, an unusual tone of voice, and difficulty understanding other points of view. Other social, language, cognitive, behavioral, and emotional deficits are present as well.

Treatment for this developmental disorder includes behavior interventions and medication. Prognosis is dependent, in part, on early diagnosis and intervention.

Though the cause of autism spectrum disorders is unknown, genetics and environmental factor appear to contribute to its development.

Celebrities diagnosed with these disorders include Dan Aykroyd, Courtney Love, Daryl Hannah, and Paddy Considine.

Other disorders:

Numerous other mental disorders afflict millions of Americans as well. Other depressive disorders, dissociative identity disorder, anxiety disorders, personality disorders, and attention deficit disorder are but a few. Each has the potential to be disabling, and those who suffer from these disorders sometimes experience stigma as well. 

The end of stigma:

As more people who suffer from mental illness open up, hopefully, we can reduce the pervasive stigma that surrounds mental illness. Particularly crucial to ending stigma, however, is ensuring those with the most severe brain diseases (SMI) receive appropriate and adequate treatment.

Individuals with mental illness are more likely to be victims of violence than to commit violence. That said, the subset with SMI that’s untreated does have higher violence rates resulting from psychosis. By ensuring they receive humane medical treatment to manage their brain disease (and improve their quality of life), the violence that contributes to stigma will be diminished. 

Just like any other organ of the body, our brains are prone to medical conditions. The brain is the most complex organ of our bodies. So it only stands to reason it’s subject to a variety of biological conditions. As researchers come to understand our brains better, more sophisticated diagnostic tools will be developed for a more definitive diagnosis. In the meantime, we should treat those with mental illness with the same dignity, respect, and empathy we treat someone with a physical disability, heart condition, stroke, or Alzheimer’s disease.