So what does all of this mean for a therapist-in-training?

After a thorough review of the inaccurate portrayal of mental illness in these social media posts, I as a therapist-in-training am learning how much this will likely impact not only my future work but also my personal life. As I mentioned in my first post, we incorrectly use mental illness terminology all throughout our everyday conversation. I fully admit to having been one of these people in the past, which I am definitely not proud of. It is clear from this analysis that while the intent may not be intentional harm, the indirect impact can be even more harmful. I believe I now have a responsibility to help raise awareness through my conversations with others who do not suffer from mental illness. Instead of just rolling my eyes or shaking my head at someone's insensitive comment or social media post, it's important for me to advocate for those that I work with and help others really understand the impact of this misrepresentation. I am in a position where I can help bridge the divide between those with and without mental illnesses so we can begin to build empathy and facilitate understanding. This is definitely a big mountain to climb and a feat that I cannot accomplish alone, but it's important that I do my part. Additionally, I need to continue to find resources to help me help my clients continue this work with their families and friends while they learn to cope. The issues raised in this blog could very well come up in a therapy session, and I need to be prepared to help my clients work through these issues. I look forward to continue to learn strategies and skills to not only support my clients but also advocate for the population with whom I work. We as a society have a ways to go with eliminating mental illness stigmas, but all we can do is take one step at a time. 

Adding "Schizo" to the Abbreviations Repertoire

One of the many things the millennials have popularized is the use of abbreves (abbreviations) in everyday conversations. Some examples include ridic (ridiculous), obvi (obviously), totes (totally), def (definitely), cray (crazy)...you get the point. In true American fashion, we have taken this to a new level and added a mental illness abbreviation to the list..."schizo" for schizophrenic. It's as if it becomes a more casual disorder by removing the last few syllables. As a result , our society has used this less serious form of the word to describe a mood, name a pre-workout supplement, insult a person's actions, etc. Today's post looks at how our new abbreve is minimizing the severity of schizophrenia.

Image from Facebook user's post. Name has been redacted for confidentiality purposes.

We will start today's post with a social media user's post about his "morning mood swing" and "feeling schizo." Now I'm assuming that this person probably doesn't actually have schizophrenia as they would probably not be posting emotional selfies and describing themselves as "feeling schizo." Similar to other posts on this blog, these social media posts send the message that 1) these disorders are a "mood" that can be turned on and off and 2) can be applied to anyone on any given day. This post in particular almost makes phrases like "feeling schizo" the newest witty quote to add to your everyday conversation. Posts like this anger me because it's just wrong. I personally can't imagine saying something like I'm "feeling schizo," as I find it to be so insensitive and just completely inaccurate. By incorporating phrases like this into our everyday language we are minimizing the severity of the disorder. We are also inaccurately portraying the actual symptoms of the disorder, making it even more difficult for our society to understand and feel compassion for those who suffer from schizophrenia. Therapists working with these clients will likely have to have extensive discussions about the myths and misunderstandings accompanying this disorder. Additionally, they will also have to discuss with their clients how to manage the severity of this disorder as they might not truly understand how serious it could be. Therapists in general will need to actively work to raise awareness about this disorder and how detrimental it can be to someone's life.

Image from Facebook user's post. Name has been redacted for confidentiality purposes.

This next post also uses the new abbreviation "schizo" to describe a company who's changing their mind about a movie release. We have now taken this disorder to a whole new level and applied it to an entire group of executives at a prestigious company. As we know, this adjective is completely inaccurate and insensitive. First, it would be amazing if someone who suffers from schizophrenia could be an executive of such a successful company like Sony. Second, it's unfortunate that the intention behind this post is to be insulting and take a stab at the company. We definitely should not add "schizophrenic" to the list of mental disorders that people insensitively use to insult others. Words like "retard," for example, are now taboo to use since various advocacy groups have raised awareness about the implication of these messages. The last thing we need is for "schizo" to replace "retard" into our repertoire of insults. Overall, I believe using this abbreviation and word in such an inaccurate way only moves our society further in the wrong direction of understanding mental illness. The more we use the name of these disorders inaccurately, the larger the rift becomes between those who do and those who do not suffer from mental disorders. With this divide in mind, therapists and psychologists working with patients with schizophrenia will likely need to discuss strategies for increasing awareness and understanding in their loved ones. It would be beneficial for these therapists to work closely with their client's family. To reiterate, it is important that therapists and psychologists continue to work on raising awareness of schizophrenia in our society. 

The Newest 7-Day Diet: Anorexia

With the ever-growing pressure to be thin in our society, women are constantly evaluating their weight, experimenting with the latest diet, and posting about their weight loss "secrets" on social media. Before and after pictures of women's bodies are all over Facebook and Instagram feeds to show off progress they have made with their weight. But with these successes we also have the social media confessions and complaints about overeating, need for dieting, and upcoming events that require the "perfect" body. A common way women are now expressing their need to lose weight is by proclaiming their new diet of "going anorexic for a week." Based on the connotation, this likely incorporates a combination of unrealistic daily calorie limits, over exercising (two-a-days, hours on the cardio machines, etc.), and daily weighing to confirm that the pain and emptiness is worth the gain (or loss). Today we explore the implication of this "diet" on the portrayal of mental illness in our society.

Image from Twitter user's post. Name has been redacted for confidentiality purposes.

We again return to the social media giant made famous for popularizing hashtags and continuous status updates. In the above posts we see a common theme of "going anorexic for a week" to resolve issues with weight. Some of these posts allude to losing weight for an upcoming event or as a result of overeating on vacation or over the weekend, etc. The reason why these people are posting these types of messages to the entire world is completely unknown to me; however, the underlying messages from these posts are clear. These messages imply that being anorexic can be turned on and off in the matter of a week, which those who suffer from the illness know is completely false. As indicated in the DSM-5, Anorexia Nervosa is characterized not only by low body weight but also by an intense fear about gaining weight/becoming fat as well as a disturbance in the way a person views their body weight or shape. Therefore, this illness is much more than just restricting food intake. 

By referring to this illness as a "diet," we are completely minimizing the seriousness of this disorder. I am worried about the message this sends to female adolescents and teenagers who do not fully understand the complexity of this illness. If they start believing this is a diet instead of an illness, then we are only perpetuating the issue of unrealistic body types and unrealistic measures to obtain these body types in our society. Additionally, we are sending the message that it's "normal" to significantly restrict food intake for an upcoming event or as a result of weight gain in order to meet our weight goals. This pattern of behavior is not normal, and we need to keep saying this out loud. 

For therapists working with people suffering from Anorexia Nervosa, they may need to do a great deal of work with their client to help them understand that their attitudes and behaviors are not normal and definitely not healthy. These societal messages may be reinforcing one of the primary issues with this disorder - the denial of there even being a problem. Additionally, these therapists will likely have to work with clients to develop coping strategies for dealing with the messages all over social media about weight loss and eating disorder behaviors so that their clients do not regress. Even though various groups have been campaigning to combat these messages and images, we still have a long way to go as a society before eating disorder behaviors are believed to be as severe as they really are. 

ADHD - Medicating the "Fake" Disorder

Today's post takes a different perspective on the portrayal of mental illness in social media. We are now looking at a situation at the opposite end of the spectrum. The two articles cited on this page highlight two doctors that not only claim ADHD is a "fake" disorder but also continue to prescribe ADHD medication to children. After each revision of the DSM, clinicians and the general public have their share of feedback regarding disorders, criteria, etc. However, these doctors take this to a whole new level by continuing to medicate children, which is not only unethical (and grounds for losing his license) but also sends a seriously wrong message about mental illness in our society. 

Link to Article

In our first article, we are introduced to a doctor who provides medical services to an underserved youth population outside of Atlanta. This doctor outrightly states that while he believes ADHD is a fake disease, he continues to write prescriptions for Adderall to help children perform better in school. He actually has the audacity to claim that he has no other choice in the situation, stating, "I don't have a whole lot of choice. We've decided as a society that it's too expensive to modify the kid's environment. So we have to modify the kid." Not only does this perspective completely invalidate the experience of those who do suffer from ADHD, it also sends the message that medication is a "cure all" for our problems, whether or not it's related to mental heath. Additionally, this doctor is implying that we can do a better job servicing kids with special needs in school, which could very well be the case, but this does not mean he needs to take the matter into his own hands with prescriptions. While I agree that there is a chance ADHD is over-diagnosed, I am infuriated that someone would assume that kids require medication to succeed in school and then abuse their license to write these prescriptions. For therapists who are working with those who suffer from ADHD, they may struggle to collaborate with the patient and family around alternative or combined treatment options. The underlying issues may lie in parenting styles, family dynamics, or another issue that cannot be solved by Adderall. Additionally, therapists may run into issues with families who are searching for an ADHD diagnosis and medication treatment as soon as their child starts having academic and behavioral problems in school so they have a justification for the behavior. It would be in everyone's best interest if this doctor left this practice ASAP.

Link to Article

In our second article, we hear from "the scientific doctor of ADHD" who asserts that ADHD is a fake disorder. However, this doctor earned his living off of ADHD prescription drugs, which to me comes across as a complete contradiction. I would describe this man as a phony who just wanted to make a ton of money. Similar to the first article reviewed, this message invalidates the experience of those who have been diagnosed with the disorder. Regardless of his perspective, these people are suffering academically, socially, and emotionally and he is completely taking that away from them. However, he is also implying at the same time that they should keep taking the medication since it makes him so much money (again, completely contradictory). If I suffered from this disorder and heard that "the scientific doctor of ADHD" discredited his own work, I would feel lost and hopeless and even more confused about how to cope with my issues. I worry about how some people may feel after reading this doctor's claims. For therapists working with clients with ADHD, they may need to address this idea of a "fake disease" with the client if that person feels their experience isn't valid. The therapist should also probably prescribe medication sparingly to ensure that it is actually the most effective method of treatment in addition to psychotherapy. 

With all of this said, we are not doing anyone a favor by telling them their disease is fake but they should keep taking prescription drugs. This messaging reinforces the desensitization of mental illness in our society and the use of medication to solve all problems.  

The Ease and Joy of Treating Anxiety

At some point in our lives, we have all felt anxious about something we were experiencing or would experience in our immediate future. This is completely normal and part of being human. For instance, you may have felt anxious leading up to an upcoming test, job interview, first date or even felt it in the middle of a presentation, performance review, etc. For many of us, this anxious feeling likely went away after using various coping strategies like taking a deep breath, saying positive thoughts, etc. For some the feelings dissipated after actually confronting the event, at which point you were then completely comfortable in the situation. Keeping our personal experiences in mind, it is important to note that for someone who suffers from an anxiety disorder, "getting over it" is much more involved than 10 deep breaths and an internal monologue with phrases like "it's okay." In today's post we dive into a discussion around the sarcastic depictions of anxiety disorder treatments that we see posted all over social media.

Link for image: https://www.pinterest.com/pin/266205027949295927/

Everyone reading this who suffers from anxiety disorder is probably screaming, "I WISH!" If only it were that easy to treat anxiety. Similar to some of the earlier posts on this blog, the criteria noted here would mean that we all can suffer from an anxiety disorder simply by caring. Additionally, we are implying that a change in a mindset is as simple as just "forgetting it." Again, images like these are minimizing the severity of the disorder as well as the complexity of treatment. When I read this card, I get the impression that those who suffer from anxiety should be able to quickly turn it on and off. These impressions therefore could impact my ability to show empathy and understanding for the severity of this disorder. When these messages permeate, those of us who do not suffer from anxiety struggle to understand why those affected are so debilitated. There's also a chance that people who suffer from anxiety also internalize these messages and feel frustrated and defeated with the treatment process. Therapists and psychologists working with these patients may need to spend a great deal of time working through these misconceptions and frustrations so that they can learn to accept their anxiety and be patient with their recovery. There also may need to be a layer to the treatment where they discuss how to educate the client's loved ones to break down their misconceptions as well. Therefore, treatment extends beyond coping strategies to addressing societal pressures and stigmas around the disorder.

Link for image: http://www.kappit.com/img/90153/going-on-klonopin-is-the-new-vacation/

We now shift our focus from the easy treatment of "forgetting about it" to the "joy of medication." In today's society, medication can often be the go-to treatment for disorders since it involves the least amount of work. In the picture above, Klonopin, an anxiety medication, is depicted as such a relief that it feels like a vacation. For those of us reading this, we may then assume that a quick pop of a pill is the cure-all for anxiety. However, this depiction of anxiety medication is missing some pertinent information. First, finding the medication that works best for you can take an extensive trial-and-error process, which can be extremely exhausting and frustrating. Second, many of these medications have less-than-desired side effects that sometimes are not worth it despite the relief from anxious symptoms. It's definitely not just a "good time." Third, medication is not a cure-all - psychotherapy is a key component of the treatment process that is left out here. This depiction leaves me feeling disheartened and almost annoyed because I know there is no such thing as a "vacation" from a mental illness. It also worries me for my future as a therapist because I know many people have internalized these messages and may therefore not want to do the work in psychotherapy. Therapists and psychologists today likely have clients that come in expecting a one-time visit for medication. Therefore, they may lack the motivation to engage in psychotherapy, which will negatively impact their recovery. Additionally, they may become quickly frustrated if their medication regimen is not working or if they're not experiencing that "vacation" when they take it. It's important that we bring to light the reality of medication so that people understand the complexity of treatment and have patience with themselves and their psychologists through the process.

#PTSD

Today's images come to you straight from the social media forum known for popularizing hashtags. The mental disorder featured today has been the focus of a great deal of media attention in the recent years due to our country's involvement in overseas wars - PTSD. However, PTSD can result from a variety of traumatic events, including but not limited to "exposure to war as a combatant or civilian, threatened or actual physical assault (e.g. physical attack, robbery, mugging, childhood physical abuse), threatened or actual sexual violence (e.g. forced sexual penetration, alcohol/drug-facilitated sexual penetration, abusive sexual conduct, noncontact sexual abuse, sexual trafficking), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war, natural or human-made disasters, and severe motor vehicle accidents" (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 2013, p. 274). 

While reviewing the following posts, keep in mind the types of events the DSM-5 notes as being "traumatic." 

Image from Twitter user's post. Name has been redacted for confidentiality purposes.

Our first post includes an image of a mutant from a popular science fiction TV show. Note the "PTSD flashback" reference in the post. While some may find humor in the dramatic reaction to a character that was originally created using a trash can and plunger, this image and caption completely minimize the severity of images one may experience in a PTSD flashback as well as the emotional and physical response. A typical reaction to this image may be, "Ahhh!! Hahahahahah!! I'm totally having a PTSD flashback right now!!!" However, someone truly experiencing a PTSD flashback may experience sensory, emotional, and physical reactions. Some may even experience a dissociative state where they actually believe they are in that moment. These states can last a short as a few seconds to as long as a few days (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 2013, p. 275). This silly post, therefore, portrays a PTSD flashback as a simple jump, giggle, and maybe even a quick experience of fear. I find this depiction and caption to be insensitive to those who are suffering from this condition. This social media user is clearly oblivious to the distress this type of experience has on those with PTSD. Because of posts like these, therapist and psychologists working with individuals with PTSD flashbacks may have to help their clients understand that they are not overreacting or "crazy" for having such an intense emotional, sensory, and/or physical reaction to these experiences. These therapists will likely also need to work closely with the family to understand the severity of the situation and the impact this has on the client's life. PTSD flashback are no joke, despite the portrayal of these experiences in social media. 

Image from Twitter user's post. Name has been redacted for confidentiality purposes.

Our next post is written by a mother in reference to her child's hair cut experience. Now, to this mother's defense, we all know that young children and hair cuts are NOT always the fondest of memories. The crying, screaming, and outright embarrassment leaves you begging to never cut your child's hair again, especially not at the same hair salon or barber shop. However, comparing a simple hair cut to "torture" that is going to cause PTSD is completely ridiculous and insensitive. Similar to our mutant image above, comments like that are minimizing the traumatic events that actually leave someone in complete distress. Based on the criteria set in this post, every parent in the world suffers from PTSD! Again, I am frustrated by the lack of awareness and acknowledgement of what this condition really means for those who suffer from it. I'm sure that someone with PTSD who reads this post wishes this could be their most traumatic experience. These types of posts put our therapists and psychologists in situations where they need to help their clients understand that 1) this is a serious disorder that they need to treat and 2) they should not feel ashamed of the trauma they have experienced. I can only imagine how isolated these people may feel from society when they see that their possibly debilitating condition is apparently affecting all of the "normal" people around them.

In reflecting on my past conversations, I definitely recall times when I've thrown in a dramatic phrase (using a mental illness) to create a wittier, more engaging story. However, after taking a step back, I realize the insensitivity I was showing towards those who actually suffer from conditions like PTSD. I was completely contributing to the desensitization of mental illness in our society. As a result, I'm definitely going to choose my words wisely next time I'm creating that "dramatic twist" in my story. 

How are we misrepresenting mental illness?

Link for image: http://www.clickypix.com/wp-content/uploads/2013/11/funny-ocd-pictures-16.jpg

When casually browsing your favorite social media pages, you can find countless examples of people dropping names of various mental illnesses to describe the stressors of their life, their reaction to someone in the news, their difficult roommate, or some other personal issue. For some, this may even be the latest trending hashtag associated with a nostalgic picture from college or a funny meme that we have re-posted on our Facebook wall. Additionally, many of us say things like, "It's giving me anxiety," and, "I'm so ADD right now," in casual conversation without meaning any harm. However, the more we use these terms in passing and without a second thought, the more we are desensitizing society to what it actually means to suffer from these illnesses. In this blog I hope to bring to light how much we are "throwing around" this terminology and the impact that has on those suffering from these illnesses and the treatment they receive.