Mental Illness: The Non-Casserole Disease

A friend who has written extensively about families with mentally ill children told me that people refer to mental illness as the “Non-Casserole Disease.” I thought I knew what she meant, but asked her to clarify.

“So if you find out that someone has broken a leg, or is going through chemotherapy, you bring over food to help out. But if you learn that someone’s teenage son is diagnosed with bi-polar disorder, or your friend’s husband has major depression, you stay away. No casseroles…Is that right?“ 

“That sums it up,” she told me. 

This avoidance extends into the workplace, community activities, social events, and family gatherings. If you or a member of your family is known to be suffering from mental illness, people tend to treat you the way people with cancer were treated decades ago. Back then, if you had cancer you didn’t tell anyone for fear you might be fired from your job or socially isolated. This has changed for those with a diagnosis of cancer, but not for people with mental illness, which is often disclosed with trepidation in fear of what others might say or do.  An employee might ask for time off to see a dermatologist to look at a possible melanoma, for example, or for a physical therapy appointment for a bad back. But how many will mention that the appointment is with a therapist because of chronic depression? Stephen Hinshaw, a well-known psychologist, wrote a memoir, “Another Kind of Madness,” about growing up with a mentally ill parent and the stigma attached to him and his family. His experience affected him throughout his adulthood. And yet the prevalence of mental illness is so great that if people with mental illness were clustered together, not many people would be left who never suffered from some form of mental disturbance. The National Alliance for Mental Illness (NAMI), in a review of the prevalence of mental illness, reported that about one in five adults will suffer from mental illness in a given year. Also, over the course of an adult lifetime, one adult in 25 will have a serious mental illness that affects work or other life activities.

So something doesn’t compute. Those not bringing the real or virtual casseroles to the home of someone suffering from a mental illness are likely to have a family member or friend or themselves suffering from depression, anxiety, panic attacks, obsessive compulsive disorder, or any of the other myriad forms of mental disease. National surveys have estimated that about 40 million people suffer from mental illness. In contrast, according to the Centers for Disease Control, about 29 million people suffer from diabetes. Somehow we all seem to know someone with diabetes, but do we all know someone with mental illness? We probably do and don’t know it. Unlike the diabetic who sees no problem in talking about cutting out carbohydrates or their attempts to lose weight, very few mentally ill will discuss their latest problems with their medication, or complain about the misery of the side effect of weight gain.

How many television programs have characters who are living normal lives with mental illness? When people with mental illness are depicted at all, it is usually to show them in a totally dysfunctional state or creating mayhem. Rarely, if ever, is someone with mental illness seen living a normal life. He or she may be struggling with the symptoms of the disease, but somehow still manage to work, have a family, a social life, and the same worries and celebrations as everyone else. The closest we come to viewing this is in advertisements for antidepressants with the stock character able to go for walk along the beach, or hike through the woods after taking the advertised medication.

Is it any wonder then, that those with mental illness hide the information from co-workers, acquaintances, and extended family members? I have a friend with a grandchild unable to go to college because she developed generalized anxiety soon after graduating high school. When asked what her granddaughter is doing by casual acquaintances, I noticed that my friend changes the subject. She doesn’t want to mention that a grandchild is mentally ill. Yet she will easily discuss another grandchild’s recent diagnosis of Crohn’s disease, an autoimmune disorder, because, in her view, there no stigma attached to this. It bears repeating that many fewer people suffer from the autoimmune disease when compared those experiencing the anxiety disorder.

Why is my friend with a mentally ill grandchild reluctant to mention such a common problem? Why the stigma, reinforced in light of that the sad thing about all of this; is that taking that casserole (or simply yourself) over to the home of someone with mental illness may be very important for the mental health of your friend, neighbor or family member. Maintaining friendship with families with a child or adult member who is experiencing mental disease allows the family to feel less isolated from normal social activities. We are easily sympathetic when someone we know talks about the side effects of chemotherapy, radiation, or the problem of monitoring blood sugar levels. But how often do we feel comfortable hearing a co-worker describe the unpleasant side effects of his antidepressant medication? Indeed, is this ever mentioned, except to others who are also diagnosed with mental disorders?

Mental illness is simply an illness. It may not be necessary to bring a covered dish or a roast chicken to the patient or family. (Does anyone do this anymore?) But patients with mental illness deserve the same kind of support, sympathy, and understanding we give to others who are undergoing an acute or chronic illness.

It is time to stop the secrecy.

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