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Dr. Ali Mattu has an excellent You Tube Channel that provides quality information about issues within the field of Psychology. They are informative as much as they are entertaining.

His last video, “How to Talk to People About your Mental Illness“, brought up a very important conversation and provided advice on how to go about doing something which everyone with mental illness struggles with at one point or another: How, whether, and to whom do you disclose information regarding mental illness.

I reached out to Dr. Mattu with some thoughts I had which he appreciated and approved my sharing of them. He wisely added that “I’ve come to see these videos as the start of a conversation, not a definitive end.” Here they are (lightly edited for grammar 🙂 :

Hi Dr. Mattu,

I saw your video “Talking to people about Your mental illness.” It was a thoughtful handling of a very important topic. As someone who has researched mental illness stigma over my graduate school career, I had some thoughts pertaining to the video – in particular, points #3 and #4.

Within romantic relationships, the question of when to disclose is an important one. In line with the idea that you brought up, that mental illness is only part of your story, not the whole story, you want to first get to the point when the individual gets to know you deeply as a person. At that point, learning of your mental illness will be understood in context of your person. I don’t know if comfort is always the best indicator of best time to disclose – some may never feel comfortable disclosing.

Along these lines, I don’t know if I agree with the advice given to the med school applicant. I think when it comes to applications, there are lots of variables, one of which is the particular mental illness. Mental Illness stigma varies depending on the diagnosis. Additionally, some illnesses are more chronic than others. Bipolar disorder, for example, may be something which can be a red flag to application reviewers, given that medical school conditions (sleep deprivation, extreme stress) are risk factors for a manic or depressive episode.

Since the med school application is just a snapshot of the person, a personal statement which includes details of ‘scars’ from mental illness – can place disproportionate emphasis on the disorder and obscure the reviewer from seeing the whole person. While I do believe there is increased awareness of mental illness and stigma is on the decline, med school acceptance is a numbers game, and any risk can be the difference between acceptance and needing to wait another year to re-apply. I applaud those who are strong enough to do so, but they should understand that for many, the stigma is very real.

Lastly, when you addressed publicly disclosing one’s mental illness, you focused on the proximal impacts of the disclosure (e.g. loss of sleep), but when making such a decision its important to weigh the potential long term personal and professional consequences. For example, here is tweet from Elad Nehorai, a journalist:

“I am bipolar. I am proud of this, and I have spoken about it openly. The goal was to help people feel empowered to speak about their own mental health challenges. Unfortunately, as I have become a more “controversial” voice online, people have used this as a weapon.

Since information when publicly share is available to people who don’t know you as a whole person, some people will (very unfortunately) attribute your behavior and words to the mental illness rather than you as a person.

Maybe this is just the sacrifice that brave individuals with mental illness can choose to make in order to weaken the societal stigma overall. But it can be a very real sacrifice and they should be aware of that when making the decision.

Thanks for the work that you do.

Elliot Kaminetzky, Ph.D.