Gray matters: The weight of a label

“Mentally ill” is a label that joins the lovely category of things that, despite not being explicitly real, do have real consequences for those ascribed this identity by others.

I’m referring to the notion that mental illnesses, particularly mood disorders and other mental illnesses with a broader variation of symptoms, are social constructs.

Like gender and race, people are given a social label in regard to their mental health, based on absolutely nothing concrete or legitimately traceable. These statuses only matter because somewhere in the development of civilization, some idiot decided they should.

And now we all have to suffer the consequences.

Like I mentioned, the label “mentally ill” can carry a significant and unnecessary social burden that exacerbates symptoms of the supposed illness.

In sociology, primary deviance is a term used to describe a deviant behavior that has not (yet) resulted in a public label. For example, a man who has never stolen anything in his life decides to steal a young child’s bike because he is late for work.

And although it’s weird to see the man use the tiny bike to pedal his way to his Wall Street job, especially since he decided for some reason to continuously use the bike horn and twirl the handlebar’s tassels, the public doesn’t really care.

Secondary deviance is a term used to describe deviant behavior subsequent to a label that the public puts on someone.

Stealing one bike did not really hurt the man’s self image. But the next day when  he finds himself stealing another kid’s bike (this second one was blue!), the public begins to suspect that this will be a regular thing. They call him “bike stealer” as he gaily passes through cars on busy streets.

The man begins to identify with the label “bike stealer,” and so he continues his particular brand of deviance as a response to his new label.

These terms are also applicable to mood disorders. If someone has been feeling sad, and they visit a psychiatrist who eagerly tells them they have depression and gives them medicine, it makes sense that the patient will associate themselves with the term “mentally ill.”

And we may expect that the further association with a term like this very well makes symptoms worse than they need to be. These are psychological disorders; they can be affected and shaped by the way we think about them. If someone regularly experiences symptoms of sickness, they are going to start acting like they are sick.

People seeking to remove the stigma surrounding mental illness seek to make the label “mentally ill” less impactful on a person’s psyche and reduce the consequences of the label.

But, should we really seek to remove all stigma? After all, although mental illness is largely a social construct, there certainly are biological and chemical correlates.

And besides, acquiring a label to describe how one has been feeling can be liberating, as can work to remove personal responsibility.

When my psychiatrist agreed with my assessment that I primarily had symptoms of generalized anxiety disorder and obsessive-compulsive disorder, I remember feeling relieved. I couldn’t be that crazy if I was still labellable.

Without that label, I might have just remained feeling uncomfortably and amorphously neurotic.

But, those labels also invite room for social stigma, and critically, detach a person from their thoughts. And that is an issue.

I did not like admitting this for a long time, but our decisions have a tremendous impact on how our mental illnesses manifest themselves. The more depression or anxiety expresses itself, the more we identify with it and the more we feel helpless to do anything about it.

It is a perfectly difficult cycle to escape, and despite my efforts to, there does not seem to be an easy way.

According to psychology, a mental illness is a health condition involving changes in emotion, thinking or behavior; they are often associated with further distress or difficulty functioning in social, work or family activities.

The most common treatment is cognitive behavioral therapy, pioneered by Dr. Aaron T. Beck and largely unchanged in the last hundred years.

A neuroscientific perspective of mental health is more aligned with biology and chemicals related to feelings. A neuroscientific, biological treatment would be medication.

Studies have shown that antidepressants alone work quite well and are comparable to psychotherapy in reducing symptoms, and doing both works slightly better than either alone.

But ideally, we may develop treatments that are not so dependent on subjects’ internal dedication to changing themselves and are more dependable.

With stigma comes the ability to assign someone a weighty label that they might struggle with intensely to try and escape.

Removing the stigma means that the labels become less weighty and may even go entirely out of fashion.

Although, without stigma, people will probably not get solace from being labeled. But they will also no longer even feel the need to be solaced because they care less about what their minds are doing.