This morning my friend told me she has breast cancer. I listened numbly as she described finding the lump, getting the diagnosis, and making plans to begin chemotherapy.
“Bald by Valentine’s Day,” she sighed. “The hardest thing is telling people. I don’t want to tell the story over and over. I don’t want people sobbing over me and I don’t want them thinking of me as a cancer patient.”
“So, if you didn’t have to tell, you wouldn’t?” I asked.
“Absolutely,” she said.
I understood her desire not to talk about her illness. But I also know that hiding serious illnesses is a very bad idea.
In 1966, when I was 12, my mother was diagnosed with manic depression. For nine years, during the spring and summer, my mom would rise at 4:30 each morning and, before I woke, she’d have cleaned the house and made dinner. Then she’d practice the piano, do house projects, and read classic literature or weighty books about foreign economies. As fall approached, her mood plummeted. She’d stay in bed for much of the day. She would cry, turn jittery, and become unable to make even the most inconsequential decisions. By November, her mantra of “I’m a terrible mother” would play over and over, like a skipping record.
My father, brothers, and I never told anyone about her illness. My uncle and my parents’ best friends would offer help when my mother was in the hospital, but none of them knew about the incessant crying, hand wringing, and pacing we witnessed on a daily basis whenever mom was depressed. They didn’t hear her unremitting laments about not knowing what to cook for dinner, how to clean the house, or how to discipline my brothers and me. To them my mother was beautiful, smart, and reserved.
Because they didn’t know the truth, nobody ever asked my brothers or me how we were doing. They couldn’t image how hurt and scared we were.
In 2009, my adopted daughter was diagnosed with bipolar disorder. She stole her cousin’s cell phone. She lied about everything. She befriended a pervert she’d met on the Internet and climbed out her second story window in the middle of the night to meet him. She insisted a heroin addict was the love of her life and got angry when I wouldn’t let him visit our home.
Although my daughter had three psychiatric hospitalizations, saw a psychiatrist monthly, and attended therapy sessions weekly, my husband and I hid her illness as best we could. We feared she would be stigmatized and we didn’t want people to think poorly of us as parents. But because our friends and relatives weren’t allowed to see our pain, it never occurred to them to ask how we were doing or to offer help.
Many families hide mental illness, depriving themselves of the natural support system vital to coping with any illness. That silence doesn’t just harm families. It hurts people with mental illness and it hurts society.
We need only contrast progress made in understanding and treating cancer, a disease without shame that’s difficult to hide, with the lack of progress made understanding and treating mental illness to know that keeping illnesses secret is counterproductive.
- Over the past several decades, the proportion of the population diagnosed with cancer has declined and more people survive cancer. In contrast, the number of persons diagnosed with mental illness continues to grow.
- We have drugs that target molecular and cellular changes caused by cancer and vaccines that can prevent some cancers. In contrast, we have only the most rudimentary knowledge about brain chemistry and many of the medications to combat mental illnesses are either ineffective or fraught with debilitating side effects.
Strategies for improving the lives of people with mental illness and their families begin with improved funding for research. In 2013, the National Institute on Mental Health’s budget was less than $1.5 billion. In contrast, The National Cancer Institute’s budget was approximately $5.8 billion. But adequate funding for research about mental illness will not exist until we truly understand the number of people struggling with mental illness. And that requires that people stop hiding.
Talking about illness is painful for individuals. It makes it possible that others will see them in a different light. But not talking about illness is even more painful.
During the fourth game of the World Series, everyone in the stadium took part in Major League Baseball’s "Stand Up To Cancer" moment. If we couldn’t hide mental illness – if mental illness made us go bald – maybe Major League Baseball or the National Football League or the National Basketball Association would have a “Stand Up to Mental Illness” moment. And then we would all be better off.