While there is debate over the roles of biological susceptibility and psychosocial factors in triggering the onset of mental illness, it’s also worth giving some thought to how the illness experience is shaped by social factors vs. biologically-based symptoms.
Once we are ill, we experience symptoms that are influenced by neurophysiological processes, regardless of whether the origin is genetic, environmental, or more likely, somewhere in between. At a basic level, these symptoms are going to be pretty consistent regardless of the social world we are surrounded by.
Most of us don’t live in a box, though, so we’re inevitably members of a social system, at least to some extent. Our whole lives, we are socialized into the system we belong to, which includes learning group norms, beliefs, and expectations.
This means we grow up learning, consciously or unconsciously, how our social system views mental illness. When we become ill ourselves, all of that baggage from our early socialization hits us like a Mack truck. It doesn’t suddenly go away just because we happen to develop the illness. The symptoms themselves may feel heavy, but we also have to carry around the weight of being a person with a mental illness.
In grad school, I learned about social constructionism, a sociological theory that essentially says that reality as we experience it is shaped by social systems. This means that our subjective experiences and the meanings we ascribe to those experiences are inextricably linked to our social worlds. This theory has been applied to mental illness to suggest that it’s impossible to separate the biological, objectively “real” effects of the illness from what our social environment has taught us about what it means to have that illness.
This made a lot of sense to me. Even though I’ve been significantly affected by the biologically-based effects of illness, there is so much more to the illness experience than that. There are the effects of dealing with people who don’t “get” what mental illness. There are the significant effects of stigma, which are profoundly social in nature. If I could have experienced depression in a milieu in which mental illness was considered valid, I might be in a very different place in life than I am today.
Meanings and mental illness
There are so many meanings that society attaches to mental illness that aren’t actually inherent in the illnesses themselves. Beliefs that mental illness represents weakness, not trying hard enough, not being positive enough, not being good enough, or being unpredictable, frightening, dangerous, are all social factors that hold us back from living the lives we want to live.
Imagine what it would be like if mental illness was considered “normal” and treated with the same acceptance and respect that tends to be afforded to people with cancer. Would it make the illness easier to cope with? Even if the symptoms were still there, I think this kind of change in socially ascribed meanings would make the experience of being ill at least a little bit easier.
Have social factors played a significant role in your own illness experience?