The Free Press, Mankato, MN

Special Report: Mental Health

May 27, 2012

Suffering in Silence, Part 2: Denial, wishful thinking fuel stigma



In general, there is now more public acceptance for many types of mental illness and people are more ready to accept help, said Gregory Nelson, a Mankato Clinic psychologist.

Hoping for zebras

When Mankato Clinic physician assistant Todd Leech first sees a patient, he typically tries to rule out a physical diagnosis before settling on a psychological one. That’s a typical method in medicine — make a list of the possibilities and investigate the most common, dangerous or easily treatable ones first.

Leech often tries to rule out physical diagnoses first. Thyroid disorder, for example, can mimic mental disorders, but it’s very rare, he said.

The aphorism is: “When you hear hoofbeats, look for horses, not zebras.”

Patients are sometimes the ones looking for zebras.

Soper said, “A lot of people want it to be something more physical. Something easier to explain and accept. A brain tumor.”

This inclination is natural, given the stigma. A physical cause can be cured. But “mental illness” means something is wrong with your brain, your seat of perception, not with your kidneys or your small intestine.

One of the sources of stigma is the fact everyone has some control over their own mental state. If I can pull myself out of the dumps, the thinking goes, then someone who can’t is simply being mentally lazy.

For Schaefer and others, though, it’s work to even stay healthy, knowing you’ll never be cured.

For a lot of us, it’s like climbing a mountain,” Schaefer said. “You still make that effort.”

Schaefer once saw some children knocking down birds’ nests. He didn’t do anything and later decided he had to work on being less passive. It’s the quest for self-improvement everyone faces, Schaefer included.

Everyone has self-pity open to them,” he said.

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Special Report: Mental Health