It's not your imagination: things you must know about anxiety, depression and other emotional disorders that affect one in every three individuals

Abstract

When we seek to know more about the history of psychiatry and mental illness, we find at our disposal an eclectic set of readings: from the wise and deeply scientifically grounded book of Edward Shorter, the History of Psychiatry1, to the fantastic philosophical and archival development of Foucault with his History of Madness2. Despite the wide variety of speeches and opinions that these readings display, all of them strongly agree on one point: the stigma of mental illness has existed since time immemorial, long before the birth of the discipline psychiatry. One might mistakenly think that the issue of prejudice against mental disorders and against their bearers is a thing of the past, an issue of the Middle Ages, time of the famous witches hunt. Today, after nearly two hundred years of the existence of psychiatry and with so many discoveries about the brain, provided by neurosciences, the persistence of this sort of discrimination would be incompatible, once it derives from an archaic era. Nevertheless, this is a mistaken idea. If we look at the international literature on the stigma of mental illness, we can observe that every year increasingly more works are published from all over the world on the issue3. The Revista de Psiquiatria Clinica itself recently showed results from the first national study in Brazil about stigma4. In the current days it is clear, for example, that stigma causes immense losses to people with mental disorders: years of delay between onset of the disease and diagnosis, refusal to seek help to avoid discrimination, lack of treatment resources in the public health system and so on5. Once stigma is still present, persisting nowadays and being highly prejudicial, how do we fight it? Information. This is one of the most important tools in this fight. And information needs to be accurate, scientifically based and accessible to persons who have no technical knowledge about mental health issues6, 7. The authors Naiara Magalhaes and Jose Alberto de Camargo managed to achieve this goal uniquely with the work It’s not your imagination (Nao e coisa da sua cabeca). The opening chapter is one of the most robust and conceptually polished. “To begin with” (“Para comeco de conversa”) begins with a description of the situation of social invisibility of a person with mental disorder, a situation in which many people are. Figures are high and impressive: people live on average 13 years with depression before seeking treatment for the first time. At another point in the book figures rise to impressive 36 years when it comes about phobias. The authors point out the lack of information and stigma as important causes for this harm to persons. Through interviews with renowned professionals in the area of mental health in Brazil, authors then explain with stunning clarity how mental illness would be the result of social and biographical injuries allied to a “biochemically fertile soil”, the vulnerable brain. At the end of the chapter the book’s goals are stated: to clarify the tortuous paths by which our mind functions and to provide a “more peaceful coexistence with the diseases of the soul”.