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 Would You Rather Be Violent & Dangerous or
Docile & Incompetent? Gender & the Stigma of
Mental Illness
Jed Diamond, Ph.D. has been a health-care professional for the last 45 years.
He is the author of 9 books, including Looking for Love in All the Wrong Places,
Male Menopause, The Irritable Male Syndrome, and Mr. Mean: Saving Your
Relationship from the Irritable Male Syndrome . He offers counseling to men,
women, and couples in his office in California or by phone with people throughout
the U.S. and around the world. To receive a Free E-book on Men’s Health and a
free subscription to Jed’s e-newsletter go to www.MenAlive.com.

I’ve been a mental health “professional” since the age of five. My father was
42 years old and I was 5 years old the year he tried to commit suicide. I made a
decision way back then, though it was not a conscious one, to find out why my
artistic and creative father wanted to leave his family and to leave his life behind.
When I was about the age he was when he made his first suicide attempt, I found
a journal he had written, which gave me a window into his world.

Crazy Like My Father

January 4:

"I feel full confidence in my writing ability. I know for certain that someone will
buy one of my radio shows. I know for certain that I will get a good part in a play.
Last night I dreamt about candy. There was more candy than I could eat. Does it
mean I'll be rewarded for all my efforts?"

June 24:

"Your flesh crawls, your scalp wrinkles when you look around and see good
writers, established writers, writers with credits a block long, unable to sell,
unable to find work. Yes, it's enough to make anyone blanch, turn pale and
sicken."

August 28:

“A hundred failures, an endless number of failures, until now, my confidence,

my hope, my belief in myself, has run completely out. Middle aged, I stand and
gaze ahead, numb, confused, and desperately worried.”
October 5:

“All around me I see the young in spirit, the young in heart, with ten times my
confidence, twice my youth, ten times my fervor, twice my education. I see them
all, a whole army of them, battering at the same doors I’m battering, trying in the
same field I’m trying.”

November 8:

“Yes, on a Sunday morning in early November, my hope and my life stream

are both running desperately low, so low, so stagnant, that I hold my breath in
fear, believing that the dark, blank curtain is about to descend. My hope and my
life stream are both running desperately low, so low, so stagnant, that I hold my
breath in fear, believing that the dark, blank curtain is about to descend."

Although his journals told a story of a man who was sad and depressed about
his inability to find work in the creative field he loved, at home he was often
angry, judgmental, and withdrawn. He would yell at my mother, then disappear
for days.

Five days after his last journal entry, he took an overdose of sleeping pills.
Although he didn’t die, our lives were never the same. He was sent to a mental
hospital. I was sent to school to learn my ABCs. Neither one of us adapted well
to our surroundings. He ultimately escaped from the mental hospital after being
incarcerated for 9 years.

I tried to be a good boy. I tried not to rock the boat. I tried to be smart and
logical about my life. I was terrified of my emotions and secretly sure I would turn
out like my father. I thought if I became a doctor I could magically protect myself
against his fate and save him, and men like him, from mental illness. I went into
medical school, but felt stifled. One day I walked out. Or at least I tried to walk
out. I had to see a psychiatrist before they would allow me to leave. Anyone
who wanted to get out of medical school, when most people would kill to get in,
must be crazy.

When I left medical school, the lid came off of my emotions. I let myself feel
again. Once I let go of control of my feelings, I found that I was happier and also
more depressed. My emotions went up and down. When I was diagnosed as
being bipolar (manic-depressive) I felt the stigma of being labeled “mentally ill.”
But I also was able to get help, support, and good treatment. I could better deal
with the ups and downs of my life and I didn’t have to attempt suicide as my
father had done.
Gender, Depression, and Stigma

My PhD study was titled, Male vs. Female Depression: Why Men Act Out
and Women Act In. I introduced the study this way:

“Women seek help—men die.” This conclusion was drawn from a study of
suicide prevention by Angst & Ernst. They found that 75% of those who sought
professional help in an institution for suicide prevention were female. Conversely
75% of those who committed suicide in the same year were male. Since
depression is a significant risk factor for suicide and men receive less treatment
for depression than do women, it is vitally important that we have a better
understanding of the way depression manifests itself in males. Failure to
diagnose and treat depression can lead to significantly increased morbidity and
mortality.

I found that depressed women often “act in” as a result of gender-role

conditioning that emphasizes both the expression of feelings and focus on
internal judgments of their own inadequacies; while men are conditioned to “act
out” and externalize their sense of hopelessness, helplessness, and
worthlessness. Men often express their depression by drinking, getting angry,
and withdrawing physically and emotionally.

A recent research study demonstrates these gender differences in how we

deal with our unhappiness and how society stereotypes certain kinds of behavior.
As Rick Nauert, PhD, reported in an article about the study, “Most would agree
with the statement that the mentally ill do not get a fair shake in this country.
Many employers don’t want to hire them, and health insurers don’t want to treat
their illnesses.”

He goes on to say, “There have been many efforts to combat the stigma of
mental illness, but with limited success at best. That’s in part because the
stereotypes are so powerful: Mental patients are either violently dangerous or
docile and incompetent. We fear the first and disdain the latter. These are not
equal opportunity stereotypes, however. The image of dangerous mental illness,
including violent alcoholism, is much more often directed at men. Similarly,
women are much more likely to be caricatured as pathologically dependent and
depressed.”
 The study was quite interesting. Psychologists James Wirth of Purdue and
Galen Bodenhausen of Northwestern, authors of the study, wanted to know if
these gender biases contribute to the harmful stigma of mental illness.

Specifically, they suspected that when the mentally ill act “out of character,”
violating the stereotype, they might arouse more of our sympathy and leniency; if
it’s more uncommon, it’s probably more authentic. By contrast, we might be more
apt to blame and stigmatize the mentally ill when they conform to stereotype.

The psychologists decided to explore this provocative idea with a national

survey. They had a group of volunteers from around the country, varying widely
in age, education, and socioeconomic status, read a case history of a person
with mental illness.

Some read about Brian, who was a stereotypical alcoholic, while others read
about Karen, who showed all the classical symptoms of major depression. Still
others read switched-around versions of these cases, so that Karen was the one
abusing alcohol and Brian was depressed. The idea was to see if the typicality of
Brian and Karen’s symptoms (or lack of it) shaped the volunteers’ reactions and
judgments.

And it did, without question. As reported in Psychological Science, a journal of

the Association for Psychological Science, the volunteers expressed more anger
and disgust — and less sympathy – toward Brian the alcoholic than toward Karen
the alcoholic, and vice versa for depression.

They were also more willing to help Brian and Karen when they suffered from
an atypical disorder. Most striking of all, the volunteers were much more likely to
view Brian’s depression (and Karen’s alcoholism) as genuine biological disorders
— rather than character defects or matters of personal irresponsibility.

What this suggests is that stigma-busting campaigns need to closely consider

the potentially powerful role of intersecting stereotypes in shaping when and how
mental illness stigma is expressed.

In this era of increasing stress, I believe most of us are susceptible to

becoming depressed or drinking too much. But, I suggest that men have a more
difficult time acknowledging their depression and women have more time
admitting to problems with drinking. If our choices are between being violent and
dangerous or being docile and incompetent, most men would choose the former
and most women would choose the latter. Which would you choose?

If we are going to deal with the stresses of life, we are going to have to get
past our stereotypes and acknowledge that we are all suffering. We need to
reach out to each other, not stereotype and stigmatize. We need to heal our
relationship to the earth, each other, and ourselves.
 For more information about my work, feel free to contact me at:
www.MenAlive.com