Unfortunately, mental health problems are sometimes seen as a sign of weakness. This view can be held by unaffected individuals as well as the sufferers themselves, who believe that they would cope better if only they were stronger characters. Here, we discuss why this is NOT the case and why this myth is unhelpful and can even be harmful.
Bronte
Georgina
“1 in 3 people experience a psychiatric disorder at some point during their life”
No single personality type explains mental illness
Mental health problems do not discriminate – they affect people from all walks of life and are incredibly common, with up to 1 in 3 people experiencing a psychiatric disorder at some point during their life (1-3). A wide range of personality traits have been studied in relation to mental illness, including, neuroticism, introversion, disinhibition, conscientiousness and perfectionism (4-6). The bottom line is that no single temperament or personality type explains mental health problems. This is exemplified by looking at well-known people who have spoken publicly about their experience of mental illness. Victoria Pendleton, Alistair Campbell, Demi Lovato, Jonny Wilkinson and Dwayne “The Rock” Johnson have all been affected by mental illness, despite their very different personalities.
“We should be in awe of the amazing tenacity that many people with mental health problems display on a daily basis”
Living with mental illness is HARD
For many people with mental health problems, simply getting through the day requires huge reserves of energy, determination and mental strength. Let’s take obsessive-compulsive disorder (OCD), as an example. Think about a young person with OCD who gets up at 4am everyday so that they can carry out 3 hours of counting rituals before they go to school. What about the mother with OCD who checks her baby every 10 minutes during the night and spends hours every day sterilising her baby’s toys. Are these people weak? Certainly not! We should be in awe of the amazing tenacity that many people with mental health problems display on a daily basis.
The causes of mental illness are highly complex
If mental health problems aren’t explained by “weakness”, then what are the causes? We know that genetic and environmental influences are both important (7,8). There is no single gene for depression, anxiety or any other common mental health problem. These conditions are polygenic, meaning that hundreds or thousands of genes influence them, with each individual gene exerting a small effect (9-11). Similarly, a wide range of environmental experiences, such has stressful life events, are likely to be relevant to the development of mental health problems in the population, with any one experience playing a relatively small role (12-14).The causes of mental health problems are highly complex. Luckily, large-scale studies such as the GLAD Study give us a good chance of understanding the causes and courses of psychiatric disorders with the hope of eventually improving treatments for individuals.
Many people recover from mental illness
Recovery rates are increasing, with the development and dissemination of effective treatments. For example, approximately 60% of people with anxiety disorders respond to cognitive behaviour therapy (CBT) and 73% of the responders make a full recovery in the long term (15). Cognitive behaviour therapy is not an easy treatment, nor one that can be passively received. In fact, the patient is required to take ownership of their recovery by using specific cognitive and behavioural techniques. In the case of anxiety disorders, CBT typically involves the patient confronting situations that they fear, both with the therapist and on their own in between sessions. In this sense, CBT requires great determination from the patient. Regardless of the route to recovery, overcoming a mental illness shows tremendous resilience and strength. To quote Walt Disney, “All the adversity I’ve had in my life, all my troubles and obstacles, have strengthened me”.
“The myth that mental illness is a sign of weakness is stigmatising”
So far we have talked about why mental health is not a sign of weakness. But you might be thinking: “Does this really matter anyway?”. In a word, yes! The myth that mental illness is a sign of weakness is stigmatising, and may have particularly negative consequences for certain subgroups of the population, such as men. Unfortunately, the idea that men are considered weak if they are struggling still exists today, with phrases like ‘man up’ being thrown around thoughtlessly. This leads to many men refraining from seeking help or talking about their feelings, for fear of not being considered ‘man’ enough, which often just perpetuates the problem. Furthermore, in some instances the belief that mental illness is a sign of weakness may directly exacerbate psychiatric symptoms. For example, it may fuel the feelings of inadequacy and low self-esteem that are key features of depression. Lastly, this myth also implies that mental illness is a choice and that people can just “snap out of it” if they put their mind to it. This is inaccurate and unhelpful because it discourages people from seeking help and accessing the effective treatment that they deserve.
References:
1. Merikangas KR, He J-p, Burstein M, et al. Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry. 2010;49(10):980-989.
2. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry. 2005;62(6):593-602.
3. McManus S, Meltzer H, Brugha T, Bebbington P, Jenkins R. Adult psychiatric morbidity in England, 2007: results of a household survey. The NHS Information Centre for health and social care; 2009.
4. Jylhä P, Isometsä E. The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depression and anxiety. 2006;23(5):281-289.
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6. Smith MM, Vidovic V, Sherry SB, Stewart SH, Saklofske DH. Are perfectionism dimensions risk factors for anxiety symptoms? A meta-analysis of 11 longitudinal studies. Anxiety, Stress, & Coping. 2018;31(1):4-20.
7. Waszczuk MA, Zavos HM, Gregory AM, Eley TC. The phenotypic and genetic structure of depression and anxiety disorder symptoms in childhood, adolescence, and young adulthood. JAMA psychiatry. 2014;71(8):905-916.
8. Kendler KS, Prescott CA. A population-based twin study of lifetime major depression in men and women. Archives of general psychiatry. 1999;56(1):39-44.
9. Wray NR, Ripke S, Mattheisen M, et al. Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression. Nature genetics. 2018;50(5):668.
10. Purves KL, Coleman JR, Meier SM, et al. A major role for common genetic variation in anxiety disorders. bioRxiv. 2019:203844.
11. Howard DM, Adams MJ, Clarke T-K, et al. Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions. Nature neuroscience. 2019;22(3):343.
12. Krebs G, Hannigan L, Gregory A, Rijsdijk F, Maughan B, Eley T. Are punitive parenting and stressful life events environmental risk factors for obsessive-compulsive symptoms in youth? A longitudinal twin study. European Psychiatry. 2019;56:35-42.
13. Liang H, Eley TC. A Monozygotic Twin Differences Study of Nonshared Environmental Influence on Adolescent Depressive Symptoms. Child Development. 2005;76(6):1247-1260.
14. Arseneault L, Milne BJ, Taylor A, et al. Being bullied as an environmentally mediated contributing factor to children’s internalizing problems: a study of twins discordant for victimization. Archives of pediatrics & adolescent medicine. 2008;162(2):145-150.
15. Kodal A, Fjermestad K, Bjelland I, et al. Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of anxiety disorders. 2018;53:58-67.
