I suspect everyone can agree that it’s not easy or entertaining to have a chronic illness, or even a very serious acute illness that can be sent to remission with possibility of relapse. It’s even less entertaining to have one that many people believe is “all in your head.”  Actually, it’s just mostly in my head. (That’s what the professional writers call a joke). In fact, it’s in my brain.

The neurobiological basis of “mental illness” is no longer a controversy in the medical community.1 The general public, however, isn’t quite there yet, to put it politely. One of the most difficult things about living with a brain disorder2 like bipolar disorder is the need to persuade people that you’re sick.  Part of that is the “but you don’t look sick” phenomenon.  People with autoimmune disorders who “look” quite healthy, but may in fact have some significant limitations, know all about this.3 Some days I may seem quite lazy, when in reality I’m having one of those fatigued days that are all too common for people with MS.  But another part of it is that many people simply don’t believe that “mental illnesses” are real.

Again, I’m going to go to comparisons.  Imagine anyone making the remarks below to someone with cancer:

            I know how you feel

            You’re just being dramatic

            Why don’t you get over it and get on with your life?                  

            You’ll get better if you really want to; you’re just not trying hard enough

Those would seem pretty ridiculous, no? Exchange any number of diseases for cancer, and I suspect your response would be the same. But these kinds of comments are what people with brain disorders (fka mental illnesses) commonly hear once they announce a diagnosis.  Some of us might even say we “admit” a diagnosis because the stigma is so pervasive.  But many of the remarks reflect simple ignorance.  And part of that ignorance is perpetuated by the language we use.  And by we, I mean all of us – the medical profession as well as the “civilians.”  I believe language changes can actually undermine the ignorance and stigma.   


 1 Which is not to say that there aren’t dissenting physicians, but rather to note that it is quite well settled that the brain disorders commonly known as “mental illness” are biologically based.

2 I intentionally use the term “brain disorder” instead of “mental illness” in attempt to underscore the concept of its status as a biological illness.  My goal is to create a day when these illnesses are described as “the brain disorders formerly known as mental illnesses.”  I may in fact simply begin to refer to them in posts as “brain disorders (fka mental illness)”.

3 For an excellent discussion of this phenomenon, read The Spoon Theory.