How to Have a Better Conversation About Mental Illness

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SYDNEY, Australia — As public conversation about mental health has grown louder and busier in recent years, mental illness has become more than a category of disease with social and psychological dimensions. Especially in the case of depression and anxiety, mental illness has come to be seen as a proxy for what is wrong with the modern Western world.

Depression is like a Rorschach test: People see in it whatever they like, in order to make whatever point they like, about what they perceive to be the ills of society. Blame for depression is found in capitalism, loss of religion, social media, processed food. Recently a book was released promising to tackle anxiety “for good” with a two-week sugar detox.

Much good has come of the increased willingness to discuss mental disorders. There is greater acceptance than in the past that mental illness is real and common, and that when it arises, its causes are complex and cannot be explained away as weakness or lack of character. All of this is vital in reducing stigma, which in turn encourages people to step forward and seek help without shame.

But as a doctor who works in mental health, I think the direction of the conversation should give us pause. I work in a public hospital where our patients include those with many conditions that have been slower to shed stigma, such as schizophrenia, mania, severe depression and personality disorders. This stigma differential is something I feel keenly when observing which diagnoses patients will or won’t accept.

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