Iowa Alumni Magazine | October 2007 | Features

Opening Minds

By Shelbi Thomas
A sociology class shatters stereotypes about mental illness.

Students in Bridget Conlon's "Sociology of Mental Illness" class explore the effects and perceptions of mental illness in society.

Angry depressive, psychotic, or psychopath? Soon after authorities declared Cho Seung-Hui the gunman in this past April's Virginia Tech massacre, TV commentators scrambled to identify the mental disorder behind the deadliest mass shooting in American history. No one knew for sure whether Cho was paranoid or schizophrenic, but one thing was clear — he fit society's perceptions of the mentally ill.

"You hear about mental illness, but not because a person with it is doing something good," says graduate teaching assistant Bridget Conlon, 02MA, who instructs the UI's "Sociology of Mental Illness" class. "The media focuses on the bad news, because violence sells better, yet the percentage of people with mental illness who commit violence is very small."

In a six-week course this past summer, Conlon challenged students to set aside their preconceived notions about mental health and approach the subject from a fresh, sociological perspective. Forget deranged madmen with extreme and rare disorders — for a more accurate representation of the mentally ill, just take a look around. Nearly half the people in the U.S. will have a mental illness at some point during their lives, according to the National Institute of Mental Health, and one-fourth of Americans meet the criteria in any given year. In other words, mental illness is as common as heart disease or cancer, and it affects your co-workers, family, and friends.

Conlon devotes a whole class period to defining this health epidemic that afflicts millions of people worldwide. Attitudes on what constitutes a mental illness have varied with time and culture, but generally, it's considered to be a condition that causes distress and disrupts a person's thought, mood, or behavior. Mental illnesses fall into several major classes, which include disorders related to mood, anxiety, substance abuse, psychoses, development, and personality. The most common conditions today are major depression, alcohol abuse, specific phobias (such as arachnophobia), and social phobias (such as performance anxiety).

These and many more illnesses appear in the American Psychiatric Association's Diagnostic Statistical Manual of Mental Disorders (DSM), a two-inch thick "bible of psychiatric disorders" with which Conlon's students soon become familiar. Translated into 22 languages since its inception in 1952, it's gone through four major revisions and seen its original 60 entries quintupled. The latest edition includes descriptions and classifications for more than 300 types of mental illnesses, everything from anorexia to voyeurism.

As a sociologist, Conlon researches these disorders differently than a psychologist or biologist would. While the clinical approach focuses on the body and chemical imbalances in the brain, sociology looks at external factors, such as environmental or social stresses. "Very early on in the class, we discuss the different perspectives and how they are not mutually exclusive," says Conlon. "Combining insights from both biological and sociological views will get us farther than fighting about which is more accurate."

Many of Conlon's 12 students have never considered this sociological viewpoint before. The psychology majors, in particular, are surprised by how much the two approaches have in common. "I'm used to understanding mental illness on an individual level," says Anthony Spurgetis, a senior psychology major from Rock Island, Illinois. "This sociology class allows me to study mental illness from the perspective of groups of people."

The students explore several major sociological theories that try to explain mental illness. Labeling theory says that classifying someone as mentally ill often causes them more distress and stigma than the actual illness. Structural strain theories claim that economically and socially disadvantaged people actually have more distress, but that lack of access to health care makes them less likely to be diagnosed with a mental illness. Social stress theory explains how life events, such as holiday celebrations, moving, and divorce, can affect a person's mental health. According to this theory, people with strong coping resources, such as family support and high self-esteem, find it easier to bounce back.

With a history of mental illness in her own family, Conlon doesn't just want her students to assimilate theories — she wants them to understand the devastating impact that mental illness can have on people's lives. She assigns movies, biographies, and first-person accounts that aim to counter a strong yet misleading stigma. "People usually think [the mentally ill are] violent, deranged, dangerous, poor, worthless to society," says Spurgetis. "This class tells us that mental illness doesn't just happen to a certain group of people; anyone can suffer from one of these disorders."

Epidemiologic studies reinforce Spurgetis's point. Mental illness reaches across lines of gender, race, ethnicity, age, and socioeconomic status. Impulse control and substance abuse disorders affect men in greater numbers, while anxiety and mood disorders are more common in women. Predictably, people with lower education and less income face more stressors that can lead to higher rates of mental illness.

Some studies show that African Americans and Hispanics are generally less likely to suffer mental illness than Caucasians, while Asian Americans are less likely to admit to a mental illness, don't seek treatment as often, and have higher suicide rates. Native Americans suffer from higher substance abuse and suicide levels than the general population, and a larger percentage of them have more than one mental illness at a time.

Unlike physical conditions, mental illnesses often strike at particular times in people's lives. Substance abuse or mood disorders typically show up when people are in their late 20s to early 30s, while anxiety and impulse control disorders tend to appear earlier. People who experience mental illnesses such as depression early in life, though, will likely suffer relapses.

Family life also affects chances for developing a mental illness. Married men face less depression than married women, although no differences have been found between single men and women. The hardships of running a single-parent household are reflected in higher rates of mental illness in such families.

"You're more likely to have a mental illness if it runs in your family for both genetic and environmental reasons," adds Conlon. "For example, parents with depression have a more difficult time forming a healthy attachment to their children, which can affect those children later on."

Despite everything that experts know about mental illness, many important questions remain unanswered. An unprecedented 44 million Americans are currently estimated to suffer from some form of mental disorder. Have the pressures of modern life caused this increase? Are doctors better at detecting and treating mental illness — or have they turned minor health problems and eccentricities into phobias and disorders?

Changes in attitudes across time and culture make it hard to compare rates of illness. Religious beliefs, societal norms, and cultural traditions all impact views and treatments. At various times, for instance, homosexuality has been viewed as a sin, a mental disorder (it was listed in the DSM until 1973), or a genetically determined fact of life.

To complicate matters, unknown numbers of people are misdiagnosed and treated when they aren't actually ill, while an estimated two-thirds of people with mental illness never receive help. Conlon explains that the stigma associated with mental illness has long kept people from seeking treatment. As recently as the 1950s, the severely mentally ill were locked in asylums and subjected to shock therapy and lobotomies to alter their "troubled" personalities.

Today, thanks to psychotherapy and pharmaceuticals that target chemicals in the brain, people with mental disorders can reduce their symptoms and play a more active role in their communities. Conlon hopes that teaching about outdated perceptions will lead to improved understanding and acceptance of such people and their illnesses.

Perhaps because of events such as the tragedy at Virginia Tech, lunatics and serial killers still dominate media portrayals of the mentally ill. Even so, Conlon is heartened by more sensitive and accurate depictions.

The Oscar-winning 2001 movie A Beautiful Mind, starring Russell Crowe as real-life Nobel Prize winner and schizophrenic John Nash, invited audiences to enter the mind of a gifted math genius who "saw the world in a way no one could have imagined."

Meanwhile, the popular and critically acclaimed TV show Monk revolves around an obsessive compulsive former police detective worthy of an entire chapter in the DSM. Yet, each week, even as he displays yet another neurosis, Monk inevitably solves cases that baffle veteran law officers.

"Rather than see mental illness as a weakness or a problem, you can say that it contributes to diversity," Conlon tells her class. "There's a richness in the experience of people with mental illness."