Erasing the Stigma of Mental Illness

Erasing the Stigma of Mental Illness

– John Newmark, M.S., LMHC


There are a wide variety of disorders classified as “mental illnesses” in the United States, ranging from depression and anxiety disorders, addictions and personality disorders to schizophrenia and a vast number in between.

Each year an estimated 43 million Americans over the age of 18 suffer from some type of mental illness, a staggering number which amounts to a huge percentage of the total adult population; while these cases may vary significantly in severity from “minor” depression to extreme schizophrenia, a mental illness is classed as ‘serious’ if the condition interferes with a person’s daily functioning and/or going about their day-to-day activities.  Left untreated, they can disrupt and destroy our lives; and often do.

The statistics, compiled recently by SAMHSA (Substance Abuse and Mental Health Services Administration) is much the same as their last 2012 survey, which indicated that of the adult population in America, approximately 20% experience a bout of some sort of mental impairment on an annual basis.  This estimate is believed by some to be even higher.

The figures are there, the statistics tell the story; mental illness may be a disruption in day-to-day functioning but at approximately 20% of the population it’s difficult to make a case for it being strictly ‘abnormal’ or in any way deserving of stigma; for those who suffer from these conditions, it should also be comforting to know that they are not alone.


For those who experience mental illness, whether it be a six-week incident once during their lives or an ongoing diagnosis of a chronic mental disease, those who are afflicted with mental disorders often find their lives altered drastically by their diagnosis.

While many instances of mental disorders can be quickly and successfully treated through the use of medications and/or comprehensive counseling, society’s reaction and judgment can often be both ignorant and simpleminded, resulting not only in unnecessary and painful stigma but incidences of discrimination that can last a lifetime.

Stigma is often subtle, often taking the form of fear and avoidance,  uncertainty, and it can often have a significantly negative impact on factors such as family life, income and employment, social standing and a variety of other factors.

Erasing the Stigma

Over the past few decades, society has been moving slowly toward an awareness of stigma around mental illness; whereas the word ‘stigma’ is defined by many unflattering terms such as ‘blame’ and ‘dishonor’, there are those who are beginning to realize through mental health awareness that mental illness is not a valid reason to automatically label a person as “unfit” or “dangerous.”

From artists and celebrities such as Michelangelo, Beethoven and Van Gogh to Charles Dickens, Ernest Hemingway, Catherine Zeta-Jones, Elton John, Jim Carrey, Kurt Cobain and Sinead O'Connor (just to name a few);  there are a variety of public figures coming forward to speak about their difficulties in this area, and while society is slowly grasping the idea that imposing stigma on those who suffer from mental illness seems archaic and ignorant, for those who are currently or have been in the grips of a mental disorder, it’s still a crushing reality.

For those who have been victimized by stigma, there are several things they can do to try and cope; first and foremost, getting help is vital and the second is to remember not to blame themselves or take it personally.

“Stigma” has existed for many thousands of years in a variety of different contexts and is not unique to any one person; it is a construct of the human mind and internalizing it can be both unproductive and detrimental to healing.

If you’re a victim of stigma due to mental illness, be sure to talk to a mental health professional about ways to cope and heal; from speaking out to viewing your own healing process in a positive light, there are many methods for you to go about living with your illness and building a positive, constructive future.

LIVING WITH ANXIETY: What Am I So Afraid Of ? By: John Newmark, M.S., LMHC

Is It Fear or Anxiety?  Is There a Difference? 

Yes, there is a big difference…

In people with anxiety disorders, the brain’s “hard drive” that controls the fear response goes awry.  At the core of this part of the brain is the amygdala, a structure that flags incoming signals as dangerous or worrisome and communicates with other parts of the brain to put the body on alert.

Early life events, especially traumatic ones, can impact this circuitry so that it is oversensitive and sends out alarms too often.  We have to perceive real threats in order to survive, but those with anxiety see threats where there aren't any, perhaps because emotional memories or defective genetics color their perceptions.

Typically, those who suffer from prolonged anxiety experience a range symptoms, including:

•    excessive worry about health, money, family, work, or school—even when there are no signs of trouble
•     irrational expectations of the worst outcome in most situations
•     inability to relax
•     irritability
•     insomnia
•     tiredness
•     headaches
•     muscle tension
•     difficulty swallowing
•     trembling or twitching
•     frequent urination

These symptoms are severe and distressing enough to make individuals feel extremely uncomfortable, out of control and helpless. Anxiety disorders fall into a set of separate diagnoses, depending upon the symptoms and severity of the anxiety the person experiences.  The anxiety disorders discussed here on anxiety are:

•    Generalized Anxiety Disorder (GAD)
•    Panic Disorder (including panic attacks)
•    Social phobia (also known as social anxiety disorder)
•    Specific phobias (also known as simple phobias)
•    Obsessive-Compulsive Disorder (OCD)
•    Post-traumatic Stress Disorder (PTSD)

What is the treatment for anxiety?

There are a variety of treatments available for managing anxiety, including several effective medications and specific forms of psychotherapy. In terms of medications, buspirone (Buspar) is known to be quite effective for treating GAD. However, it seems to be less effective in managing many other disorders that often co-occur (are comorbid) with GAD. Therefore, specific members of the selective serotonin reuptake inhibitor (SSRI) and the selective serotonin and norepinephrine reuptake inhibitor (SSNRI) drug classes, which are also approved by the U.S. Food and Drug Administration (FDA) for effective treatment of GAD, are prescribed more often. Examples of SSRI medications include fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). Examples of SNRI medications are venlafaxine (Effexor) and duloxetine (Cymbalta). Although buproprion (Wellbutrin) is primarily known to primarily treat depression, preliminary research suggests that it may not be very helpful in the treatment of anxiety; sometimes making patients feel more agitated.

Benzodiazepine medications like clonazepam (Klonopin) and lorazepam (Ativan) are more useful in stopping severe anxiety symptoms, like those that occur in panic disorder or in posttraumatic stress disorder rather than the ongoing worry that is usually associated with GAD. Although alprazolam (Xanax) is often used to treat panic attacks, its short duration of action can sometimes result in having to take it several times per day. Medications from the beta-blocker family (for example, propranolol [Inderal]) are sometimes used to provide rapid relief of the physical symptoms associated with a panic attack. Some individuals who suffer from severe panic attacks may benefit from treatment with neurontin (Gabapentin), which was initially developed to treat seizures, or may benefit from a neuroleptic medication like risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), or aripiprazole (Abilify). Zolpidem (Ambien) has been found helpful in treating the insomnia that can often be a symptom of anxiety.


Before SSRIs and SSNRIs became available, medications from the group known as the tricyclic antidepressants (TCAs) were often used to address panic disorder. Although TCAs have been found to be equally effective in treating panic attacks, SSRIs and SSNRIs have been proven to be safer and better tolerated. Therefore TCAs are used much less often than they used to be. When used in the appropriate person with close monitoring, these medications can be quite effective as part of treatment for panic disorder.

For individuals who may be wondering how to avoid panic attacks using treatment without prescribed medications, natural remedies may be an option. While treatment like hypnosis and herbal supplements that contain kava have been found to be helpful for some people with some anxiety disorders, the research data are still considered to be too limited for many physicians to recommend treatment with other natural remedies like valerian or passionflower. Also, care should be taken when taking any dietary supplements, since dietary supplements and "natural" remedies are not regulated in terms of quality, content, or effectiveness.

The psychotherapy component of treatment for anxiety disorders is at least as significant as the medication treatment. In fact, research shows that psychotherapy alone or the combination of medication and psychotherapy treatment are more effective than medication alone in overcoming anxiety for both adults and children  The most common type of therapy used to treat anxiety is cognitive behavioral therapy (CBT). This form of therapy seeks to help those with an anxiety disorder identify and decrease the irrational thoughts and behaviors that reinforce anxiety symptoms and can be administered either individually, in group therapy, and even in partner-assisted therapy. CBT that seeks to help the anxiety sufferer decrease the inclination to pay excessive attention to potential threats has also been found to be helpful.

Behavioral techniques that are often used to decrease anxiety include relaxation techniques and gradually increasing exposure to situations that may have previously precipitated anxiety in the individual. Helping the anxiety sufferer to recognize and handle the emotional forces that may have contributed to developing symptoms has also been found to be effective in teaching an individual with panic disorder how to prevent an anxiety attack or to decrease or stop a panic attack once it starts.

Often, a combination of psychotherapy and medications produces the best results. Improvement is usually noticed in a fairly short period of time, about two to three months (sometimes less). Thus, appropriate treatment for anxiety can prevent symptoms or at least substantially reduce their severity and frequency, bringing significant relief to many. There are also self-care measures that people with anxiety can do to help make treatment more effective. Since substances like caffeine, alcohol, and illicit drugs can worsen anxiety, those things should be minimized. Other tips to prevent or manage anxiety symptoms include engaging in aerobic exercise and stress-management techniques like deep breathing, massage therapy, and yoga, since these self-help activities have also been found to help decrease the frequency and severity of symptoms. Although many people breathe into a paper bag when afflicted by the hyperventilation that can be associated with panic, the benefit received may be the result of the individual believing it will remedy the symptoms (placebo effect). Also, breathing into a paper bag when one is having trouble breathing can make matters worse when the hyperventilation is the result of conditions of oxygen deprivation, like an asthma attack or a heart attack.

People with an anxiety disorder may also need treatment for other emotional problems. Depression has often been associated with anxiety, as have alcohol and drug abuse. Recent research also suggests that suicide attempts are more frequent in people with an anxiety disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself. Sadly, many people with anxiety do not seek or receive treatment.  There is no reason to suffer needlessly when treatment is so effective and available.

Myth: ‘Therapy Is Only for Treating Disorders, Not for Personal Growth’

Myth: "Therapy Is Only for Treating Disorders, Not for Personal Growth"
-John Newmark, M.S., LMHC

In my opinion and experience, It is most unfortunate that most Western philosophies seem to focus on the treatment of conditions/illnesses rather than on their prevention.  While it is true that severe mental illness often benefits from psychotherapy alone or with medication (when needed), many people find themselves lost in an ever-changing world filled with stress, confusion and chaos.   How does mental health treatment fit in this continuum?  Is counseling warranted only for the treatment of severe mental health issues/illness or is it a valid form of personal, emotional, and spiritual growth? The answer depends on who you ask.   Thankfully, the present-day shift toward preventative care has begun to manifest in many ways, especially with psychotherapy and other types of holistic approaches.

There may be aspects about yourself that you don’t want to acknowledge, even to yourself.  You may have made poor choices in your life, have leftover issues from your childhood or have trouble maintaining relationships.  Counseling with a trained and experienced therapist can pave the way to your accepting yourself, ALL of who you are.

No path to personal growth and development is ever easy.  We ALL have things we need to work through in order to become the person we were born to be. Often, patterns we learned as children can limit our happiness as adults and our growth toward becoming self-actualized human beings. Psychotherapy can help us discover and uncover places inside ourselves where we may not be able to go on our own.

If you feel that your life has become stagnant and you don’t know which way to turn,  therapy may be able to help you identify the strides you need to take in order to grow in a positive direction and keep you focused on your self-improvement goals.  I would not be the therapist that I am today without having done my own inner work; work that continues to this day…  

I would love to assist you on your journey of personal transformation and growth.

Wishing you all the best,