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Top ten myths about mental health

John Grohol, Psy.D.: Sun, Feb 1st 1998

After years of working online with thousands of people writing to us, we have gathered together what we consider to the top ten most common myths about mental health problems. Feel free to print this page out and give it to a friend, family member, or even a health or mental health practitioner. We feel that by getting the word out about these myths, we might help reduce the misunderstandings about mental disorders which seem to be so prevalent in our society today.

1. Mental health problems are uncommon.
In fact, nearly 1 out of every 5 Americans will have a diagnosable mental disorder within their lifetimes, according to the National Institute of Mental Health.

2. Mental health problems are caused by the person suffering from them.
While people do need to take responsibility for their own thoughts, feelings, and behaviors associated with disorders, they are not to blame for them. There is an important difference between taking responsibility and accepting blame, but unfortunately, many people confuse these two things.

3. Mental health problems are purely biological or genetic in nature.
Some professionals and mental health advocacy organizations feel that mistruths like this one will better forward their professional biases or political agendas, yet this remains a myth. Mental health problems are not caused by solely bad genes or a biological chemical imbalance, according to the research we have to date. Any health care professional, doctor, or mental health advocate who claims otherwise is telling you a half-truth to forward their own, unspoken agendas.

4. Mental health disorders are often life-long and difficult to treat.
So many times, individuals with a newly diagnosed disorder such as depression or anxiety are told they have to take medication for it. Yet, when they question their physician about how long they must remain on the medication, they receive a mushy, non-answer, such as, "As long as you need to." Most medications (with a few notable exceptions, such as those prescribed for bipolar disorder and schizophrenia) prescribed for mental disorders should be taken for short-term (under a year) symptom relief. Some medications have withdrawal effects that are often worse than the original problem. Quiz your doctor about these issues (length of stay on medication, plan for titrating off the medication, etc.) before you are placed on any medication for a mental disorder.

5. Psychotherapy takes forever and gets into childhood issues.
This is a myth and holdover from the older days of psychotherapy. Modern psychotherapy, however, can be short-term, solution oriented. Most short-term psychotherapy approaches use a cognitive-behavioral model, which emphasizes irrational thoughts which lead to dysfunctional behaviors and feelings. This type of therapy emphasizes learning what those thoughts are and how to easily change many of them, often in a matter only a few weeks. Most common mental health disorders can now be treated in a matter of months instead of years. Insurance and managed care plans usually cover much of this sort of treatment.

6. I can handle my own mental health problems, and if I can't, I'm weak.
The first part of this statement may not be so much a myth, as most people who have a mental health problem do not seek treatment for it. Rather, they rely on their traditional coping mechanisms (such as exercise, eating, hanging out with friends, working longer and harder, etc.) to take care of the problem. Many problems which may be diagnosable may also be mild enough for this type of care to be sufficient. Talking with friends, reading a self-help book on the subject, or visiting an online self-help support group may be enough to get you through it.

When those problems, however, become overwhelming despite your efforts to cope, that is a sure sign you need additional help. This does not you are weak -- weak-minded, weak-willed, or whatever. This means you realize and accept your human and natural limitations, and seek appropriate care when your coping skills go beyond being able to help you deal with the problem. For example, imagine yourself in a volleyball game. You go to hit the ball back for that winning point, and in the process of doing so, you injure one of your fingers. It hurts like heck, but you figure you just sprained it. For a few days afterward, you monitor the injury and hope it gets better, perhaps putting ice on it, etc. But after a few days, if your finger is still twisted and badly bruised, you might begin to wonder whether indeed it only was a sprain. You maybe consult with a friend or family member for their opinion about what to do. Eventually, you're convinced it may be worse than you thought and go to see your doctor. He looks at it and takes a few X-rays. He tells you that you're lucky you came in when you did because indeed it was worse than a sprain -- it was a hairline fracture which could have been made worse if not placed in a cast.

Are you a weak person because you sought help for your injury? Most people don't seem to much care for going to the doctor, yet we do when we have to rather than face the risk of permanent disability or something worse. Mental health problems are no different. They too can result in permanent disability or worse if left untreated.

7. If I admit I have problems, everyone will think I'm crazy and I'll need to go into the hospital for a very long time.
Crazy is a generic term which is meaningless in this context. Everybody is crazy a little bit, some of the time. Having a mental disorder really doesn't mean you're crazy though. It just means you have a problem, similar to a medical disease, which needs treatment. Would a family member or friend think any less of you for having leukemia? Cancer? The flu? Then why should they think any less of you for having depression or anxiety? If they do, they are the ones who need education and to be more open-minded.

Most people who have a diagnosable mental disorder do not need hospitalization (also called inpatient treatment). Hospitalization is only used in extreme cases, when the problem puts you in imminent risk of dying (or causing the harm or death of another). Even if you are hospitalized for your problem, it doesn't mean you will be there for days, weeks, or longer. Just like in the ER, you will be assessed, treated, and released as soon as you are feeling better.

8. Being suicidal means I'm crazy.
Suicidal feelings are most often symptoms of depression or a related mood disorder. Feeling suicidal does not make you any more or less crazy than anybody else. Suicidal feelings go away once you begin to receive adequate care for your depression or other mood disorder. That's why it is so tragic when people actually succeed in taking their own lives... Had the person been receiving adequate treatment, they could be alive and feeling much less depressed and suicidal.

9. Mental health problems are best treated by my primary care physician or a general practitioner (GP).
No matter what their field, nearly every mental health professional agrees that diagnosable mental disorders are best treated by a trained specialist -- a mental health professional. Whether that professional is a psychiatrist, psychologist, or other clinician specially trained to diagnose and treatment mental health problems, you will always receive the highest quality care and treatment when seen by one of them over a general practitioner. Mental disorders should be taken as seriously as any potentially chronic and disabling medical condition. You'd go to an oncologist for cancer, a dermatologist for skin problems, etc., etc. You should not expect or demand any less in the quality of care you receive when dealing with mental health problems. GPs are good, but it is difficult for them to keep up with the latest research in the field and often they will prescribe only a psychopharmacological treatment approach first -- the least effective treatment approach available. This will usually add unnecessary weeks of suffering onto your treatment, and often draws out the length of treatment, as opposed to a combined approach (psychopharmacology with psychotherapy).

10. Mental health professionals (psychologists, psychiatrists, social workers, psychiatric nurses, marriage and family counselors, etc.) make a ton of money off of people suffering from these disorder.
At one time in the not-too-distant past, this was true. But no longer. In fact, due to the vast expansion of managed care into the mental health field over the past 6 to 7 years, mental health care is often the lowest paying, longest work day healthcare profession. The majority of behavioral healthcare and related professionals work in this area because they want to, not because of the pay. It is well-documented that psychiatrists are often the lowest-paid physician specialty field.

Grohol, J.M. (Feb 1998). Top ten myths about mental health. [Online]. .

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