Mental illness *is* an invisible illness and an invisible stigmatized identity

A piece by Gabe Howard on PsychCentral claims that mental illness isn’t an invisible illness because its signs can be seen by viewers who know what to look for. Further, the piece claims that by “pretending” mental illness is invisible, we are failing to hold the public responsible for educating themselves about the signs of mental illness and for becoming more accepting of those who suffer from it.

What makes this argument frustrating is that it completely misunderstands what the term “invisible” means as applied to illnesses and stigmatized identities: It doesn’t mean that the condition/identity can’t be seen or suspected by an insightful perceiver. What it means is that the person can “pass” for someone who doesn’t have this condition/identity and therefore has the choice/burden to disclose or not. Therefore, most of the time (i.e., except when we’re wearing tin-foil hats), mental illness is an invisible illness. For those of us who deal with mental illness in our daily lives on an ongoing basis, having a mental illness is often also an invisible stigmatized identity.

The reason that invisibility matters is that the decision to disclose or not takes quite a toll on us, since both options can be very costly. By not disclosing we miss out on opportunities for support. For example, a person with a visibly broken leg will (hopefully) get a seat on the bus without having to reveal a lot to strangers who may or may not be helpful, while a person having a panic attack is usually going to have to stand the whole way. Opportunities for support at work and in personal relationships may be similarly lost when we just try to go along and explain our behavior in general terms like being “tired”. But disclosing can be fraught with problems too. I’m quite certain that I couldn’t keep my job if my psychiatric disorders were known at work; and in most social contexts, a very major part of my daily life is something that I’m not supposed to talk about. I worry a lot about who to disclose to, and after those rare moments when I just decide to speak from the heart, I often regret that I probably put people off by revealing too much about things that make them uncomfortable. Living a “double life” and constantly agonizing over disclosure/nondisclosure is what having an invisible illness or identity is all about.

Maybe eventually the general public will be so well-aware and accepting that those of us living with mental illness won’t have to think about these things any more. But in the meantime, let’s face it: This is the reality we’ve got.

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