People with mental illnesses may be stigmatized; they may be judged harshly and made to feel humiliated, worthless, or inferior as a result of their challenges. Stigma may lead to discrimination, which may make their mental illness worse. Dr. Rashi Agarwal, a psychiatrist and mental health expert, and Dr. Anjali Singh from MedBound Times had a fascinating and enlightening discussion regarding the stigma associated with mental health and how it affects the emotional and mental well-being of those who are dealing with mental illness.
Dr. Rashi Agarwal, MBBS, MD (Psychiatry), is a psychiatrist, mental health expert, and educator who dispels misconceptions and myths about mental health online and in person and is currently practicing in Meerut, Uttar Pradesh, India.
Dr. Anjali Singh: Hello, ma'am, and welcome to this interview session with MedBound Times. Please give a brief introduction about yourself to our readers.
Dr. Rashi Agarwal: Greetings to all. My name is Dr. Rashi Agarwal, and I work as a psychiatrist. I'm doing everything I can to dispel myths about mental health, both online and offline. I really believe that we have the ability to halt these diseases in their early stages. A theory in psychiatry called the Biopsychosocial Model contends that, in addition to our genetic make-up, our social environment, our ideas, and the people around us all have a significant bearing on our mental health. Additionally, I really believe that hormonal changes have an impact on how we feel, so if any of this sounds interesting to you, please read further to get more insights on the topic of mental health and well-being.
Dr. Anjali Singh: Okay, so let's get started with the day's first question. Mental health has always been associated with stigma and prejudice, which are still quite common today. So, could you explain the psychology at play here?
Dr. Rashi Agarwal: There is no doubt that we are moving forward in time because every day is a new day. However, it's quite upsetting to realize how much individuals have suffered as a result of the stigma associated with mental health when we take a look back to see how far we've come. As I work with patients on a daily basis, both online and offline, I notice that there is a significant lag before the patients actively seek treatment for their diseases. Some people suffer in silence for days, months, or even years at a time, and tragically, in many situations, this results in emotional, physical, and sexual abuse that could finally result in suicide. Therefore, stigma extends beyond insignificant issues or remarks like "Oh, she is so anxious, or she always cries about little things." This is just the beginning; things continue to spread and multiply tenfold in this manner.
And only the individual experiencing a mental health illness knows how challenging it is to go out and seek treatment for their ailment. These days, there are so many therapy options available, but people are afraid to speak openly about their conditions for fear of offending others. For those suffering from mental health concerns, even the act of simply coming out and asking for help or speaking with the doctor about their problems and symptoms is a major step forward. Many people claim to have improved immediately after meeting me, but this is untrue because I lack the magical abilities to instantly heal them. However, they feel validated when they come out and talk about things openly because they have been keeping things inside themselves for such a long time.
For those suffering from mental health concerns, even the act of simply coming out and asking for help or speaking with the doctor about their problems and symptoms is a major step forward.Dr. Rashi Agarwal, MBBS, MD (Psychiatry)
Dr. Anjali Singh: They gain a sense of validation and comfort that it's entirely okay to experience the things that they are experiencing, and they feel reassured that their ideas and emotions are valid.
Dr. Rashi Agarwal: That's right. Previously, they had only encountered responses like, "Oh, it's all in your head!" and "Don't overthink things and try to relax." Asking someone who has a fever to quit feeling that way is absurd in and of itself. Therefore, when we advise a person with a mental health condition to cease having certain thoughts and emotions, it is exactly the same thing.
Self-stigma makes people feel like they are the odd one out and sends them down a rabbit hole of anxious thoughts and depressive episodes by making them believe that they are overly sensitive, too theatrical, or dramatic for being themselves. De-stigmatizing mental health is crucial because social stigma feeds self-stigmatization, which over time may be extremely hazardous and damaging.Dr. Rashi Agarwal, MBBS, MD (Psychiatry)
Dr. Anjali Singh: Over time, this leads to feelings of shame and embarrassment, which eventually affect a person's self-esteem.
Dr. Rashi Agarwal: Patients come in crying their eyes out because they have been holding onto so much for such a long time. They had, at some point, come to believe that they were acting excessively, crazy, or abnormally and that this was not how normal people lived their lives.
And this is where I want to emphasize the value of group therapy, which helps patients realize they aren't alone in going through the same feelings and emotions.
Group therapies are quite helpful, especially for disorders like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and alcohol addiction, when people gather to talk about and go through their experiences with the condition. The fact that other people experience comparable emotions and behaviors as they do give the patients comfort in knowing that they aren't alone in their feelings and behaviors.
Dr. Anjali Singh: So, ma'am, have you so far seen a situation in your line of work where stigma had a profound impact on the patient's wellbeing?
Dr. Rashi Agarwal: Due to the sensitive nature of what I'll be sharing, I'd like to include a trigger warning here. I just saw a patient in the ICU who had been admitted due to poisoning. She had two girls, one of whom was three years old and the other was five years old, and the abuse had been occurring for the past five years of her marriage. As a result, when questioned, she claimed that she had two daughters, who were poisoned by her family and later died. I tend to be fairly vocal and expressive, but in this situation, I was completely paralyzed. Because of social stigma, pressure to remain in a marriage, and prejudice against divorced or single mothers, this abuse had been occurring for the past five years, but no one had considered getting her treatment. On one of those particularly difficult days, this case completely rocked me. I can't help but feel that if she had spoken up more or if her family members weren't constrained by social stigma, this situation would have been avoided.
Because there are so many treatment options accessible and so many people like me wanting to assist those in need, this incident made me wonder what more could be done to raise awareness and destigmatize mental health in society. Even as a mental health expert, one will never fully recover from it because it happens frequently throughout our lives, and the day we stop being impacted by these occurrences is the day we cease to be human. People frequently ask us if we experience the effects and how we handle them.
Dr. Anjali Singh: Yeah, because being surrounded by this day in and day out is bound to take a toll on your mental health as well.
Dr. Rashi Agarwal: Like every other human being, I also cry my eyes out every once in a while. So yes, there are days that shake you up and force you to confront the terrible realities of this world. My coworker and I were really talking about this the other night: that the physicians, lawyers, and cops are the ones that have to deal with society's squalor.
Dr. Anjali Singh: Speaking of awareness, ma'am, what could be done to increase awareness about mental health and, more importantly, to de-stigmatize mental health? To overcome the discrimination and prejudice that people dealing with mental health issues are subjected to?
Dr. Rashi Agarwal: This is how we're raising awareness about mental health right now, by what we're doing. We ought to discuss it as much as we can. The more we talk about it and bring it up in normal conversations, the more we start destigmatizing mental health. When we were teenagers back in the day, we were not familiar with terms like depression and anxiety, but when you look around today, teenagers are using statements like "Oh, she has anxiety" or "Oh, I go to therapy" quite normally in their daily conversations. Making mental health a regular topic of conversation is another way to combat the stigma. So, talking about mental health as freely as we do about physical health is certainly a step in the right direction.
But if we want to see the effects on a larger scale, we must start from the ground up, especially in schools, to teach kids from an early age that it's okay to feel and experience the things they do and to ask for help if they need it. Second, charitable groups, campaigns, and organizations can educate people and raise awareness. We also can't ignore the importance of media portrayal in all of this. And I am including all forms of media here, whether print media, broadcast media, or social media. Recently, there has been a significant change in how mental health is portrayed both during and after COVID because broadcast media, particularly our TV shows and movies, have started highlighting the significance of mental health.
Dr. Anjali Singh: So true! COVID has made people prioritize their mental health, and this awareness has only grown since then.
Dr. Rashi Agarwal: This is the time that it's shining out. Specifically, during COVID, living in an isolated space forced people to reevaluate their way of life and admit the neglect their mental health had suffered at the hands of a fast-paced lifestyle.
Dr. Anjali Singh: It's true that COVID caused us to halt and offered us an opportunity to carefully consider our feelings and emotions. We began to wonder about the quality of our mental and emotional health as a result.
Dr. Rashi Agarwal: Without a doubt! And while I don't think the media's portrayal of mental health is particularly accurate, it has at least sparked a discussion. At the same time, many shows and films did portray mental health appropriately, but with the assistance of mental health specialists, they could learn a lot more and continue to do so.
Dr. Anjali Singh: So, there's one anecdote that I would like to share: my Dadi and I are separated by two generations, so mental health and terms related to it, like anxiety and depression, are quite familiar to me; this concept of mental health and these terms were unfamiliar to her decades ago. But sometime back, when I was really down, she stopped by and inquired about my well-being and whether I was depressed. I found it amusing that she felt the need to stop over and see how I was doing, but it was also sweet. And when I asked her where she learned this term, she said it was shown in one of her serials. So, you see the kind of impact media representation can make! It's enormous if executed properly.
Dr. Rashi Agarwal: It's a wonderful feeling, yes. And one more thing I would like to add here is that we do not necessarily need to label it. Many of the people that come to me are from Tier 3 cities and rural areas, and they are unfamiliar with these concepts. Whether it's anxiety or sadness, all they want is to feel better. We want people to come to the right place at the right time to seek the correct therapy; therefore, we must educate people sufficiently so that they do not seek out black magic or any other forms of quackery.
We want people to come to the right place at the right time to seek the correct therapy; therefore, we must educate people sufficiently so that they do not seek out black magic or any other forms of quackery.Dr. Rashi Agarwal, MBBS, MD (Psychiatry)