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I am a 29 year old woman diagnosed with bipolar disorder type 1 and also suffer from general anxiety and panic attacks. I have only been recently diagnosed but have been ill since I was a teenager. I tend to have mixed-manic episodes, hence the name of my blog. I am a regular guest blogger for Black Dog Tribe. I am not a mental health professional. I am just writing from my own experiences with mental illness. If you wish to use any of my blog content please contact me at lababup@gmail.com. Visit me on twitter @lababup

Tuesday, 31 March 2015

Even mental health professionals can display stigmatising attitudes

Lots of people with mental illness experience stigma in their everyday lives. Perhaps your parents think you should be able to pull yourself together and think yourself out of your problem. Perhaps your friends believe that you have control over your illness and could do more to help yourself. If only you would join an exercise class or start eating blueberries or something, everything would get better for you.

I have come to expect these sorts of sentiments from people. Sometimes it comes from a good, albeit misinformed, place. Your loved ones are often just trying to help you with something they don’t understand. This doesn’t make it any easier to hear though when you know that you are trying your hardest and nothing seems to work.
I find myself trying to do the things that people want me to do just so that I can say to them: ‘look I have tried X and I'm doing all I can to try and get better’. Ultimately though, I know that these things won’t magically cure my mental illness. It’s more complex than that. My body has shut down and my behaviours have become strange. A switch has turned off in my brain and it is going to take a lot more than going on a jog to fix things.

Hearing these kinds of things from friends and family is to be expected. Hearing them from professionals though is quite shocking.

I once went to the GP to ask for some diazepam for my anxiety problem. I had been prescribed it by my psychiatrist but I wasn’t seeing him for a while. The GP’s response? ‘You just need to WORK through your anxiety. You shouldn’t rely on medication.’ (tone was very dismissive). I felt like I was being blamed for my illness. If only I would work a little harder, all would be fixed. I was made to feel like I was taking the easy road by taking medication. Of course, if medication is the easy road so be it. I would rather take the easy road and fix the problem than struggle down the path of yoga and raw vegetables alone.*
Maybe you wouldn’t expect a GP to have an in-depth knowledge of mental health problems. However, I would expect that a mental health support worker would have this kind of expertise. I had a very bad experience with my support worker. She forced me to do things I wasn’t ready for, she made me pay for her parking that she claimed back anyway and she asked me to buy her presents on my holiday. What most distressed me though was that she knew that I had bipolar but she didn’t believe it. When she read through my DLA application she was really shocked by the description of some of my behaviours. Her attitude? ‘I have never SEEN you behave like that.’ (strongly accusing tone). Surely as a MH support worker she would be aware that people cover up their problems.

Another time I attended an anxiety and depression group. The woman that ran the group said to us right at the outset: ‘I don’t think that any of you are ill. Mental health problems are down to bad experiences, but you are NOT ill and do NOT need medication.’ Now I am not of the opinion that only medication should be used to treat mental illness. Tools such as relaxation, CBT and mindfulness are all things that may help some people with mental illness. But dismissing the idea that mental illness should be treated with medication is dangerous. Medication helps many people and has been shown to be effective in controlled clinical trials. It is not good practice for a psychologist to dismiss medication just as it is not good practice for a psychiatrist to dismiss psychological treatments. Ultimately  of course it is a patient’s choice what methods of treatment he or she uses.
When a mental health professional says these kinds of things it’s very distressing for the patient. Anyone who has experienced a mental illness knows that they cannot control the illness by will alone. It is not a problem with strength of mind or character. It is not an easy choice to take medication. We have all experienced the side effects and the feeling that you should have been able to control the situation yourself without intervention. The fact that so many professionals have these incorrect assumptions about mental illness is deeply concerning. However, they just reflect the deeply ingrained prejudice of society in general.

A mental health professional has an important relationship with the patient. It is one in which the power dynamic is unequal. The patient is deeply distressed and desperate for help. They are fully reliant on the mental health professional for help. Most professionals are aware of this power imbalance but do everything they can to listen to the patient and advise, not dictate to them possible treatments. However, a significant minority of professionals give poor advice and demonstrate the same prejudices that uninformed members of the public have. This is all the more damaging considering the power imbalance between patient and professional.
Over the past few decades we have come a long way in tackling mental health stigma. This is partly because many professionals have gone out of their way to educate people and remove some of the stigma. I do not wish to negate some of the wonderful work many professionals do. I would not be where I am today without some of the great help I have received. However we must still hold those in power to account. When a professional holds a prejudiced view they need to be challenged, because often it is all the more damaging coming from them than it is coming from your friends and family.
*This is not to dismiss lifestyle changes. My point is that there are many treatments available to us.


  1. I feel written off because I won't take medication. I know it works for lots of people, but it's something at present I don't want to try. If I try other things and they don't work, then it may be something I consider. If I was to get so ill I couldn't work or care for my child, again it would have to be something I consider. When discussing it with a professional I felt pressured, and had it compared to drinking alcohol.

  2. That is a shame because it is your body and you should be allowed to chose the treatment that you think will best suit you. I hope that you get the help you need and you can be in control of what happens to you. Medication can be really helpful but there are problems with it too. Good luck :-)