Sunday, August 24, 2008

Stigma ! Stigma !! Stigma !!!

Most people believe that you get infected if you come into contact with bacteria. Detergent makers make money by such ads. But reality is different. It is true that bacteria are present in our environment. But whether a person succumbs or not depends on many factors. People who study about distribution of diseases in the population(epidemiologists) discuss these factors under three headings.
1) Agent related: This includes factors like the number of organisms gaining entry to your body, their ability to multiply and produce toxins (virulence) etc.
2) Host factors: Your general state of health, nutrition. Whether there has been previous exposure to the same bacteria, whether you already have other infections, your body's immunity, emotional state etc.
Relationship between outcome after cancer, heart attack or major surgery and the person's mental state has been established. The patient's emotional state is one of the variables that determine the outcome.
3) Environmental factors: Living in overcrowded, areas with poor sanitation increases the risk of infection.
In the case of mental illnesses, there are no known pathogens. Except for addictions no external agents exist.
Host factors include your genetic vulnerability, intelligence, your life experiences in the past, your mental make up etc. For most mental disorders the risk increases if you have an affected close relative. In the case of schizophrenia the risk in the general population is 1%, but if one of your parent has the illness the risk increases to 10%. It has to be emphasized that you are not inheriting the illness, but only an increased vulnerability to develop it.
Environmental factors assume much more significance in the case of mental illnesses. The circumstances of your life, family and social support etc are important.
What I want to highlight is the fact that even for infections, it is not true to say that disease is acquired as soon as you are exposed to the bacteria. Biological, psychological and social factors are important. All illnesses, whether physical or mental, have these three factors operating. The difference is only in the degree of importance.

This being the state of affairs, why do people stigmatize the mentally ill alone ? Nobody stigmatises you for getting typhoid or pneumonia etc !

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