By Dr. Steve Scholzman
Profound misunderstanding about mental illness — its causes, its legitimacy and its treatment — permeate our culture. And the stigma that accompanies this lack of understanding hurts, a lot. Take this example — hardly original or rare.
Imagine a 15-year-old adolescent girl with fairly severe depression. She may be a classmate of your child, or the daughter of a friend. Let’s call her Sally.
Sally’s not so ill that she needs to be in the hospital, but she’s close. Her family and I — her psychiatrist — are doing our best to get her better as quickly as possible so she can get back to school. She’s been out now for about three days. Why? She literally lacks the capacity to think clearly. It’s all she can do to drag herself out of her bed and run a toothbrush across her teeth.
There’s a big family history of depression so Sally’s parents are both familiar with and frightened by her struggles.
“Can you call the school and ask them to give her more time on some work?” the parents ask.
“Sure,” I say, and I get in touch with the school administrator.
“Well,” I’m told by the very well-meaning administrator, “It IS a tough time of year. The other kids are getting through it somehow. I don’t see why she should get special treatment.”
“Because she has the equivalent of the flu,” I say. I like to use analogies at these crossroads.
“But the flu feels awful. Does she have a fever? Because if she does, she shouldn’t come to school…”
“No, she doesn’t have a fever,” I say. I try another analogy. “What if she had been in a car accident, God forbid?”
“Well, that’s pretty different, isn’t it?”
“How?” I ask.
“She’d be hurt,” I’m told. “This is an entirely different thing. You’ll need to get her pediatrician to call.”
I ask the pediatrician to call, and I can feel his discomfort over the phone. “I’m not very good at making this case,” he acknowledges. “It’s probably better if you just call them back.”
(I have to wonder whether he’d be so uncomfortable if I were a gastroenterologist asking him to call the school about a patient with ulcerative colitis?) Continue reading