BEIRUT: Mental illness is not like a broken bone; it can’t be photographed or observed on the body. Conditions like anxiety, depression, bipolar disorder and others may not be immediately clear, but their effects chip away at the lives of those afflicted, many of whom suffer in isolation.In a self-generated video for the newly launched It Gets Brighter campaign, Kareem Zreik asks viewers to consider the similarities between gravity and mental illness.
Like gravity, he said, “mental illness weighs you down. It, too, is invisible,” said the 27-year-old Lebanese student, who identifies himself as having bipolar II disorder.
His video is one of a growing number of submissions on the campaign’s website, officially released on Jan. 29, by a group of students at Oxford University. On the site’s homepage, Zreik’s video and others form a patchwork of voices seeking to break down the stigma surrounding mental illness.
Georges Karam, psychiatrist and senior director at Lebanon’s Institute for Development, Research, Advocacy and Applied Care, has carried out extensive research on mental illness in Lebanon. He was one of several mental health practitioners in the country to take notice and join the cause of It Gets Brighter.
“Twenty-five percent of Lebanese will have a mental disorder at some point in their lifetime,” he said, citing data from his previous studies. The lack of awareness of mental health symptoms and the stigmatization of those with mental disorders are among the foremost barriers to getting proper treatment. He said that campaigns like It Gets Brighter shed light on misunderstood mental conditions and break through silence by starting necessary discussions on causes and symptoms.
It Gets Brighter is international in scope, seeking to gather individual testimonials across the world into a virtual space where encouragement is shared. In his 1963 book analyzing the stigmatized, sociologist Erving Goffman found that ostracized groups often find comfort and increased ability to cope when organized and in communication with one another.
Campaign organizers say that there is courage in the vulnerability of sharing a personal story, and there is power in collective storytelling to address misconceptions and stereotypes of mental illness.
“This is about creating a community of support, and building recognition that the people around us might be suffering from a mental health issue, and we might not even know it,” said Josh Chauvin, Oxford doctoral student in Experimental Psychology and campaign founder.
He has previously worked on anti-stigma campaigns in Canada, and wanted to create a campaign based on video narratives, that would gather and share the insight of therapists, family members and those suffering from a mental disorder.
Video submissions can be made anonymously for those keen to protect their privacy, Chauvin said. The site also features a list of NGOs where people can turn for help.
In a 2006 national epidemiological survey of mental disorders in Lebanon tracking prevalence and treatment, Karam, the IDRAAC founder, concluded that the rates of mental disorders in Lebanon don’t differ markedly from those in Western Europe. What makes Lebanon unique is that many Lebanese with mental health problems don’t find help. Of the 308 respondents to Karam’s 2006 study, only 10 percent had been treated.
According to Karam, the low treatment rates are caused by a number of factors, including lack of awareness, and denial that mental health conditions need professional treatment. “Some think it’s just a phase and it will pass,” he said, adding that many people wait up to 20 years before seeking help for anxiety disorders.
Lebanon’s unstable security context doesn’t help. The study also found a significant association between exposure to war-related trauma and mental health conditions related to mood, anxiety and impulse control. The compound effects of political insecurity and high poverty rates also exacerbate disorders like depression and anxiety. Suicide attempts are widespread, according to data from the WHO and the Lebanese Health Ministry, but remain underreported.
While barriers to treatment may be self-imposed, Lebanon’s weak mental health care infrastructure has a reputation for alienating those who do reach out. This past October, the Health Ministry took steps to improve the situation, launching a mental health program that would boost training of the country’s primary health care staff.
Community pressure often causes those suffering to stay silent, for fear of discrimination.
Such stigma is tightly bound with somatization of symptoms, or the manifestation of psychological illness as physical symptoms.
“People need to realize that these are medical disorders,” Karam said, explaining that a mental health condition should be viewed in the same manner as a physical health condition, rather than a mark of shame that defines a person. He also cited financial barriers to treatment as a reason as to why many are deprived of help, as private health insurance plans often don’t cover psychiatric services.
Zeina Daccache, executive director of Catharsis, the Lebanese Center for Drama Therapy, said the It Gets Brighter campaign is much needed in Lebanon. She has worked with psychiatric patients to foster creative expression of their experiences.
Describing psychiatric patients involved in her 2013 play, “From the Bottom of my Brain,” she said, “These individuals are rejected ... many of them have been judged, whether by their village, friends, or family who have labeled them as crazy or a shame to the family.”
This is exactly the problem that the leaders of It Gets Brighter seek to address. Ghia Osseiran, the campaign’s wellbeing and outreach coordinator for Lebanon, said that the conversations generated help bridge the divide and challenge the notion of “us” and “them.”
“We are a society that has long suffered from all sorts of stereotypes and stigma rooted in racism, sexism, homophobia and mental illness,” she added. “It Gets Brighter is an invitation to learn and listen instead of passing judgment.”
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