Mentally ill still subject to contempt by Arthur Caplan
(Philadelphia Inquirer) August 7 - So how far has America come in taking the shame and stigma out of mental illness? Not very far, at least if the acknowledgment by the Philadelphia Eagles’ All-Pro guard Shawn Andrews that he suffers from a mental illness is an indication.
The 335-pound Andrews, who refers to himself as the ‘Big Kid,’ had not shown up at the Eagles’ Lehigh University training camp. No one seemed to know why.
There was talk of a contract holdout. Some suggested Andrews was out of shape. Some of his teammates expressed a lot of irritation that he was not there slogging out exhausting two-a-day practices in the summer heat and humidity, wondering if maybe he just did not want to go through the misery that is an NFL training camp.
Finally Andrews, deeply hurt by all the speculation, broke his silence. He told reporters for The Inquirer and Daily News that he was battling depression.
“I’m willing to admit that I’ve been going through a very bad time with depression,” Andrews said this week in his first public comments about his training camp absence. “I‘ve finally decided to get professional help. It’s not something that blossomed up overnight. I’m on medication, trying to get better.” [Emphasis mine.]
So what was the reaction to Andrews’ admission that he has a disabling mental illness keeping him out of training camp?
You would have thought that this giant of a young man had announced that he had stayed out of camp because he was a lazy, overindulged ingrate who just did not happen to feel like playing football right now.
Talk radio in Philadelphia and around the country exploded in anger at the very idea that being sad – the talk-radio interpretation of depression – could keep you out of camp.
There was a fair amount of bashing of mental-health treatment, too, as sports talk hosts dismissed the treatment of anyone with depression as a lot of psychobabble for the rich and the spoiled. One Philadelphia sports talk host wondered why – since all psychiatrists are crazy – anyone would seek treatment from one.
It is not known what Andrews had told his coach, his agent, or the general manager of the team about his illness. But it is possible that, suffering from severe depression, which often means being confined to your house, unable to muster the energy to talk to anyone, much less eat or bathe, that he did not provide many details.
The team was fining the football player tens of thousands of dollars for his absence – a stance presumably they may want to reconsider.
But, the bigger question is: Why is it so hard for us to accept mental illness as being just as disabling and devastating as a physical injury?
Inherent in the nutty reaction to the admission of a football hero that he has a severe mental problem lies the explanation of why we have allowed our system of mental health to fall apart. Mental illness is so humiliating, so embarrassing, that individuals, whether they are in the NFL or on the assembly line, don’t want to talk about it.
Families are ashamed when one of their own cannot function because of depression, schizophrenia, addiction or psychosis. The media simply reinforce the shame of mental illness with headlines that scream of nut houses, kooks and looney-bins when a celebrity heads off for mental-health treatment.
No one would dream of calling someone with cancer a malingerer or a deadbeat. But, admit that you have a hard time working because you are depressed, cannot leave your house because you are phobic, or find it difficult to show up at holidays with your family because you are not sure you can control your eating disorder, and just watch the insults fly.
Mental illness is for too many Americans a form of moral failure, whereas physical illness is the result of bad genes, bad luck, or bad working environments.
Unless we can get past dismissing mental illness as the product either of a lack of willpower or a lack of character, we don’t stand a chance of helping those and their families who must suffer, often in silence, with the shame and stigma.
The United States barely has much of a mental-health system left. Beyond taking a pill, there is not a whole lot available in most parts of the country if you, your parent or your child suffers from depression or any other severely disabling mental illness.
If an NFL star can barely bring himself to publicly admit that he has a mental illness, then what chance do the rest of us have? And if a bruising NFL football player’s admission of a mental illness elicits little except scorn, derision and contempt, then what chance do others with mental illness have of getting the help they need?
Crazy as it may seem – not much.
Arthur Caplan is chair of the medical ethics department at the University of Pennsylvania.
As I was zipping about doing errands in my fuel-efficient mini-SUV yesterday, I tuned into the local “sports talk” radio station, and yes, they were still talking about this and, yes, they were still making incredibly ignorant and insensitive comments about Mr. Andrews and about depression in general. The level of just plain ignorance on this issue which has been betrayed by this story is truly, breath-takingly exasperating.
It was so bad that I wanted to risk the hefty fines that we now have here in The Garden State for driving while cell-phoning, but I doubt the call screener would have let me on the air if he knew that what I was going to start out by (I know, unQuakerly) saying was, “With all due respect, HOW CAN YOU PEOPLE BE SO DELIBERATELY STUPID???”
Depression is not about “being sad.” it’s about “being sick.” it’s an illness. And folks who are depressed aren’t thinking things through, so all the nonsense questioning about, “Well, why didn’t he just call somebody and tell them what was up” silly just that: nonsense. Shawn Andrews wasn’t going to be sitting home thinking to himself, “Gee, I think I might be suffering from clinical depression. I have all the classic symptoms. I guess I should call Coach and tell him that.”
No. More likely, he was just trying figure out if and when he was going to be able to just get out of bed and face the day.
But you’re smart folks. YOU know that.
Anyway, Andrews anticipates being in training camp this weekend. No word yet on whether or not the Eagles organization still intends to make him pay the fines they’ve been imposing since he didn’t show up on time, which now total over a quarter of a million dollars.
No word yet on whether there are any plans to do that. You know, the right thing.
(Question to those who know more than I do: If Mr. Andrews is indeed being treated for depression, wouldn’t he have a case under the ADA here, if he refuses to pay the fines?)
(Useful link: National Institute of Mental Health)
Filed under: General outrage, Health care, News & commentary, Philadelphia, Ranting & raving, Sports & stuff
thanks for your post. this is why i generally refer to it as ‘my chronic illness’ in general company. when i’m struggling i say “my chronic illness is flaring up.” even being an activist type sometimes i’m just not up for all the crap that can come with telling people what my chronic illness is and the extent to which i suffer from it.
Annette John-Hall from the Philadelphia Inquirer has a good column out on this today:
http://www.philly.com/philly/news/local/26410554.html
I see. It’s a moral failure to have a chemical imbalance in the brain, but it’s not a moral failure to have a heart attack because you’ve eaten eight cheeseburgers a week for thirty years and haven’t done any more exercise than what’s required by a walk to the fridge for more beer..
Yeah, that makes sense.
Off the top of my head….
I’ve worked with a couple of people who have asked for arrangements under ADA. Neither have taken it further because their employers have been willing to make adjustments.
I believe for a person to have a case under ADA, s/he has to first ask the employer for accomodations for his/her disabling illness (or condition) because the disability does not allow him/her to do the job as stated in the job description. It is assumed that the accomodations will enhance the person’s ability to perform tasks in the job description. And then the employer would have to refuse. Some employers get around this by reassigning people to new jobs–at less pay or outside the person’s best skill set. Sometimes this is a good solution; sometimes it’s dodging the issue.
Some people are willing to admit to the illness (or condition) but not to being disabled by it; others don’t want to ask for the accomodations. I’m having a hard time coming up with a sense of what accomodations a professional athlete might ask for.
I also believe that a person has to have a doctor sign off on this. I could be wrong; I’m a social worker, not a lawyer.
There are many reasons why a person is not willing to share information about their health–and perhaps Shawn Andrews has had a conversation with someone in the Eagles franchise that no one is talking about. I feel sorry for him in his position. Even if everything goes well in his relationship with the Eagles, imagine the kind of trash talk he will be subjected to on the field. And although I am a big sports fan, I know the sports ethos contains a large dose of “walk it off” and “throw some dirt on it.”
What fries my potatoes is an unwillingness by some people to consider that the brain can be sick just like any other part of the body. I know someone who has a specialist for her colitis, but not for her brain disorder. Talk about interesting (and sad) priorities.
And it wasn’t too many decades ago that cancer was a word that was never mentioned. Sometimes patients who had cancer were not told. It carried such a big stigma.
If we’ve been able to change that, surely , we can change the stigma surrounding mental illness–but not until certain parts of the media get on board. And why should they? It makes for good TV to have every serial killer be a schizophrenic, in spite of the fact that serial homicide is rare among people with that particular condition.
I see people every week who have witnessed the most horrific things and are scarred for life because of it. They get quite a bit of sympathy because someone else did it to them. And yet, the folks who have a physiological glitch in their brains get very little sympathy at all.
As for talk radio–I don’t see changes happening there for a long time, if ever.
cath
Well, I’ve finally got the talk-radio issue licked.
I turned it off.
Sadly general public does not have a good understanding of what depression is. Then again they do not have much of an understanding as to most mental illnesses that are out there. People can live day to day lives with depression, some days are good while other days are not…other times it is weeks that are just bad.
It also does not help that depression is seen as a mental illness that is over diagnosed. In some cases it is true. A person could just be going through a bad stretch of time and they figure that they are depressed, they go see their general practitioner who then gives them a script for antidepressants. Depression is indeed viewed as a crutch when someone does not show up for something, such as Mr. Andrews did not show up for the training, because they are ‘depressed’, which would translate as ‘I’m not in the mood’.
The brain is a physical part of your body and can become sick or suffer illness just as any other body part can.
The stigma still remains, mainly because there are no physical symptoms. Thus, there’s always a suspicion in the minds of many that “you must be faking it” or “it’s really not that bad.”
But when fifty percent of all Americans are on anti-depressants, I can’t see how people can be so harshly critical.
ck – there are physical symptoms. fatigue is probably the biggest one. another is eating – some people stop, others over eat, an over sensitivity to noise and light. and yes – those symptoms can also signal other illnesses, it’s often coupled with non-mood things like – forgetfulness, and changes in cognitive ability (e.g. i was having difficulty reading a health measurement instrument development book (i’m a phd student) after my illness flared up, that didn’t before it happened) and then those things coupled with a depressed mood, lack of motivation, easily irritated, issues with self-esteem, etc. and you’ve got depression.
Dick Cavett has written eloquently on the topic of depression in his blog in the New York Times.
http://cavett.blogs.nytimes.com/2008/06/27/smiling-through/
I hope that Shawn Andrews has enough close friends on the team, that getting to training camp will actually end up being a positive thing for him. I also hope that those close to him are aware that the getting better phase is the time when many people are most at risk for committing suicide. My thoughts are with him.
As for the yahoos on talk radio, I wish more people would just turn them off.
“I also hope that those close to him are aware that the getting better phase is the time when many people are most at risk for committing suicide.”
That’s a scary thought that I also had, esprecially during the time when the meds are just starting to be used.
As to sports-talk radio, I only tuned in long enough to find out what people were saying. It was all the ignorant predictable stuff. I don’t listen to that garbage at all. I’m too much of a FAN.
Great post. When I try to explain depression to people, I say it’s like having a tumor that talks you out of going to the doctor and into smoking more cigarettes.
As someone who was diagnosed as bipolar 13 years ago, I can say that this issue has caused me much frustration. I have heard “Don’t worry, you’ll get over it.” and “It’s just in your head.” more times than I care to count. People seem to don’t understand that while yes, I manage it pretty well with medication, this is a PERMANENT ILLNESS. It’s something I will live with for the rest of my life, and it is not something I can just “get over”.
Not only that, but as Furious Buddha says above, it’s like having a disease that convinces you to keep from treating it.
I feel ya. I don’t understand the ignorance since 50% of the population are on meds for depression. I guess some of those “fortunate” ones are the ignorant ones and we have to let them go through one ear and out the other, but when you are first diagnosed it’s very hard. I went to a psych ward and of course they had to inform my boss who isn’t the most pleasant personality. After a switch in meds when I got out he was his usual screaming self and of course I ended up crying at work. I was so pissed off and wanted to quit right then and there, but having thinking it through and knowing how this guy like to push buttons I did nothing. If I hadn’t been on medication or aware of my disease for a long time who knows if I’d still be here? So I’m glad this is all coming out. I pray for Shawn Andrews that they don’t charge any fines and he gets the help he needs and all people who suffer from this disease.