Have you ever been told your pulse or blood pressure is abnormally high when visiting a doctor’s office when at home your vitals are normal? There is a name for this: “the white coat effect.” This happens because is it natural to experience anxiety when going to see a healthcare provider. In fact, this happens whether or not your provider is actually wearing a white coat.
Going to see a psychiatric provider can be even more intimidating than going to see a medical provider. Exposing our most troublesome thoughts and feelings is terrifying. This terror is a result of stigma against mental health conditions. Stigma happens at a societal, familial, and personal level.
Society Stigmatizes
In the past people who were categorized as “insane” or “crazy” were separated from the self-proclaimed “normal” and relegated to asylums. It was easy to ignore their existence, so it did not matter how they were treated. In the sixties, the Kennedy administration worked towards “deinstitutionalization.” The idea was that community services would care for the mentally ill instead of keeping them in mental hospitals. Unfortunately, this has resulted in higher numbers of mentally ill in the homeless and jail populations. The success was that it made mental illness harder to ignore.
Since then, society has come a long way in acceptance. Now there is mental health month and suicide prevention month. Celebrities and other brave souls are open about their struggles making it more and more acceptable to acknowledge how you are actually doing.
Family Dysfunction
I greatly admire the young individuals who come to my office terrified and tell me of a family that does not acknowledge mental health conditions. This lack of validation from the nearest and dearest can be quite damaging. Imagine having a major depressive episode and being told “it’s all in your head” or “you would feel better if you just tried harder.” It takes immense bravery to seek help in this case.
When I worked in nursing homes, I told individuals I was there to discuss their mental health and was surprised to hear, over and over, “I don’t have mental health.” You may not have awareness or understanding, but if you have a brain, you have mental health. Some folks have better mental health, and some have worse, but everyone has it. It often seems to be younger generations who fight stigma by openly admitting that mental health merits attention.
Personal Persecution
There is nothing quite so powerful as internalized stigma. My depression once told me I was broken. It had me so convinced that I doubted the results of online tests that suggested I should see a doctor for depression. If my deepest darkest secret was that I was not worthy of living, how could I confess? At times we can be our own worst enemy. How relieved I was when my story was heard with compassion and confidence; confidence that my problems were treatable!
Whether you are working against societal norms, family traditions, or even your own brain, I applaud you for seeking help with your mental health. Everyone has mental health, and everyone deserves the support to find mental well-being. Even if you are frightened of the white coat, fighting stigma and getting help is so worth the while.
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