Dealing with the stigma of depression is far easier in the abstract than face to face, often when we least expect it. I am a clinical psychologist and I suffer from a mood disorder. Occasionally someone will remark that these dual roles are a winning combination. But sometimes they are just the reverse.
It was a packed Sunday night at the pharmacy. My fellow procrastinators and I gathered to fill prescriptions that were perilously close to the refill deadline. I looked like I'd gotten dressed in the dark-in my husband's faded Redskin's sweatshirt, purple sweatpants and a pair of running shoes that were purchased at the inception of the NIKE brand. My hair had that "should have washed it the day before, but I just didn't feel like it" style, with sections that had clearly seceded from the overall design.
Pharmacy sections are always elevated, making me feel like a supplicant rather than a paying consumer of their products. When the pharmacist looks down from his platform, I feel like I'm petitioning the Great Oz. We procrastinators stand around rolling our eyes about the wait, grudgingly admit our culpabilty for the delay, and vigorously scan for disruptions in the rightful order of service. A voice from on high calls, "Manning." I take a few steps and admit that the name belongs to me. The pharmacist aide asks innocently, but a bit too loudly, "Do you want the Lithium in childproof or regular bottles?" Moments like these make me wish for a trap door beneath my feet in which the sheer power of mortification would trip the exit, allowing me to disappear.
People looked at me differently. Not staring exactly, but sizing me up in light of new information. Now my classification as a total slob looked less like a choice and more like a condition. People may not know exactly what Lithium is for, but most of them know that it is in the mental illness arena, and it's not good. Definitely not in the antibiotic, bunion remover or indigestion classes of medicine.
I am a clinical psychologist. I have written and spoken extensively on the stigma associated with mood disorders. I have enjoined many people to throw off the mantle of shame. I knew exactly what to say to someone else. I would tell them to march right up to the counter and demand to see the pharmacist. I would script the conversation to emphasize that the violation of my privacy was totally inappropriate. I would ask of this was standard operating procedure or a temporary lapse. And I would make them insist that it never, ever happen again.
But I couldn't do it. Because I was embarrassed. Because I was afraid that if I got angry or tearful, my behavior would be filtered through the lens of my illness, and knowledge of my diagnosis would weigh heavy in subsequent interactions. It wasn't just the Sunday night fiasco at the drug store. It happens in many places where people are well meaning, which, in some ways, makes it harder to deal with. It runs rampant on inpatient psychiatric units, where behavior that is "assertive" in other contexts may be labeled as "hostile" or "acting out."
It happened with a teeth cleaning appointment, when the dental assistant reviewed a form which required so much medical detail that I worried they'd require the date of my smallpox vaccination. She sat down next to me and said, "I'm having trouble reading some of your medicines." I should have fled the room right then, but instead I asked, which one?" I was instantly aware that the other people in the waiting room, bored to tears reading old copies of AAA magazines and Golf Digest, were interested in my story. "Now, this one," she said. SAR-OH-QUIL...what's that for?" "Sleep," I answered quickly. "Great," she said. "Now there are a few more..." With each item I responded, "Sleep...sleep...sleep." While my mind was saying, "None of your damn business," my soon to be clean mouth was spouting half-truths.
It is humbling to know how easily I can give advice, rather than take it. I do well in battling stigma in the abstract- with letters and signs and speeches. All on behalf of "other people." But it's time to do the harder work. I have to summon the courage to stand up for myself. In those difficult and not infrequent moments, I'm called to challenge the ignorance that continues to paralyze me. When it comes to facing up to stigma in my own life, I could really use a dose of my own medicine.