People who have depression, dementia and other illnesses that affect the brain still suffer from social stigma. We, as a population, like to think that we are more enlightened than this, but most of us don't need to follow a study to see this stigma in action.
Insurance companies still treat mental illness separately from physical illness, even though many, if not most, mental illness has a physical component. Some policies still deny coverage for mental illness or provide less coverage.
In Social Stigma Still Evident for Alzheimer's, Dementia and Mental Illness, I wrote at length about the unfairness of this mindset. I do believe that society has made headway. Younger generations talk about depression and other mental illnesses more openly, and are more likely to seek counseling or medication. Still, a legitimate fear of discrimination underlies much of the talk.
Yet, many of our elders are still reluctant to seek counseling or any medical treatment for mental illness, and often suffer in silence rather than let it be known that they are depressed, or for that matter, even admit to themselves that they may have mental illness.
In Innovations Bring Depressed Elders Back From "Living Hell", an article published on the newamericamedia.org site, Paul Kleyman, the author, quotes "Lavern," who does not want to be named, as saying, "I don't want everybody to know I'm going here." The "here" Lavern is referring to is a mental wellness maintenance meeting.
The article goes on to say, "'There's a stigma. In this society we are really prejudiced about mental problems,' says Jesse Merjil, a therapist who guides the morning's discussion."
Depression is common in people who've had heart surgery, stroke and even those with Alzheimer's. Why should these folks be ashamed of their depression, when their heart attack or stroke history is shared as common knowledge?
Keyman writes, "...Mental illness can be set off or intensified by social isolation due to a range of factors, such as loss of family and friends, low English-language proficiency, cultural fears about mental problems or, especially, stressors related to being low income."
Depression and Alzheimer's disease
People with Alzheimer's disease can present a puzzle when it comes to diagnosing and treating depression, since they are already dealing with memory issues, and often personality changes, that occur with Alzheimer's disease. Yet depression is not uncommon in those with AD. It's hard to provide cognitive therapy to someone with severe short-term memory loss, therefore many of these people are left solely to the treatment provided by anti-depressants. Sometimes this treatment is very effective, however it may take several tries to find the right drug therapy. When a person can't provide reliable feedback, the burden of whether a medication is helping, hurting or simply doing nothing, generally lies with the caregiver.
Once a person is affected by Alzheimer's disease, the stigma of depression may not be as great as it is with someone who has no memory issues, but there is a stigma attached to Alzheimer's and other dementias, as well. Any time a person acts differently than what is considered normal, society tends to judge that person negatively. When that behavior is due to any brain disorder, this judgment, often based in ignorance, can lead to fear.
Just because a person has dementia doesn't mean that he or she can't feel the negative or fearful reactions of strangers. Certainly their caregivers are aware of this. The only answer that I can see is continued education of the public about mental illness and dementia.
People need to be made aware that any person they love could be diagnosed with depression, some other mental illness, or one of the many types of dementia. That person will need the support of family and friends. If the person with symptoms is surrounded by people who denigrate people with mental disorders, they are likely to try to cover up their symptoms rather than seek help.
For most illnesses, whether physical or mental, early diagnosis is important for the good treatment, and in many cases, survival. It seems to me that education about mental illness, as well as all types of dementia, plus awareness that these diseases can become very personal as soon as a loved one is affected, will help society move forward.
I don't expect to see the stigma disappear soon, as habits die hard. But the growth of our elderly population, bringing with it huge numbers of people being diagnosed with dementia - many of whom will also suffer from depression - behooves us to keep on educating the public about these illnesses.
People don't choose to have Alzheimer's disease. They don't choose to have depression. They don't choose to have cancer. There should be no shame in seeking treatment for any of these illnesses. Articles like Keyman's will go a long way toward helping educate the public so that eventually, we can hope, the stigma attached to illness that affects the brain becomes a sad, historical fact read about in history books.
Published On: February 08, 2011