Stigma attached to Hospitalization of patients suffering from Bipolar Disorder
35 years old Rohit told his family residing in Delhi about his extravagant expenditure of more than half a crore Indian rupees over a fortnight spent abroad. He then demanded provision of another 5 crore Indian rupees, following which his parents sought help from a psychiatrist. The mental health professionals at a reputed hospital told them that Rohit was struggling with bipolar disorder, which sets off capriciousness and emotional instability.
However, when the psychiatrists and psychologists suggested hospitalization for residential treatment using cognitive behavioural therapy and interpersonal therapy, his family members backed off, saying that admission into a rehabilitation centre or a psychiatric nursing home will lead to defamation in family & society owing to the negative stigma associated with it.
There are various forms of Bipolar disorder, but in its most harsh manifestation – manic depression – it leads to a plethora of wild mood swings which range from intense ecstasy to absolute desolation, which can last for months. While experiencing elation, the patients often become careless & indulge in gluttony and extravagance. Also, they don’t feel tired and sleepy for longer than usual time periods. When experiencing despair, they are usually devoid of energy and this is when they lose their desire for food and their self esteem. They frequently envisage plans to and sometimes do commit suicide.
The experience of stigma associated with mental illness is devastating and can be detrimental to recovery. Stigma can be defined in terms of five interrelated components: labeling, stereotyping, separation, status loss, and discrimination. Stigma is often the response to individuals who are expressing an undesirable or frightening characteristic and can be viewed as a continuum from intolerance or agitation to prejudice and discrimination. On the more negative end of the continuum, prejudice and discrimination are rooted in commonly held stereotypes that are associated with mental illnesses. These stereotypes are concentrated within an image that individuals with a mental illness are unable to make competent decisions, are dangerous to themselves and/or the public, and require coercive intervention as they will not seek treatment autonomously. In fact, the diagnosis of a mental illness is coupled with negative stereotypes regardless of the presence of abnormal behavior. Although work has been done to reduce stigma and educate the public about mental illnesses, significant barriers still exist to differentiate people with a mental illness from mainstream society
Many people want to distance themselves from someone who has a mental illness as much as they would with someone with a drug dependency or someone who has been convicted of a crime
The underlying factors which lead to development of bipolar disorder are not known yet- stress being a contributory factor.
Survival depends on one’s coping skills. Some take to smoking or drinking to cope with stress, which may be even more harmful.
Bipolar disorder can affect performance at work, and threaten both personal and professional relationships. The family should appreciate the fact that these are overworked people and should try their level best to provide them support.