For centuries, mental illness left an unseen mark that damaged the soul as well as the body. Rarely were people with bipolar disorder, schizophrenia, or borderline personality disorder treated like patients; instead, they were stigmatized, sequestered, and forgotten. What started in 18th-century dusty asylums continues to reverberate in modern, gleaming therapy offices, where stigma subtly persists in spite of our progress.
The term “treatment” was hardly used in the early days of asylums. In his in-depth investigation Shrinks: The Untold Story of Psychiatry, psychiatrist Jeffrey A. Lieberman characterized these facilities as segregation prisons rather than havens of care. His statements remarkably resemble the first-hand narrative of journalist Nellie Bly, who conducted an undercover investigation at the Blackwell Island Asylum in New York in 1887. Patients were tied down in the dark, soaked in cold water, and beaten for crying. Under the guise of medical necessity, the cruelty became accepted.
| Topic | The Untold Story Behind Therapy’s Most Stigmatized Disorders |
|---|---|
| Focus Areas | Schizophrenia, Bipolar Disorder, Borderline Personality Disorder, PTSD, OCD |
| Historical Context | From 18th-century asylums to modern therapeutic reform |
| Prominent Figures | Dr. Jeffrey A. Lieberman, Nellie Bly, Sigmund Freud, Thomas Szasz |
| Cultural Impact | Stigma, media bias, and evolving social perceptions |
| Modern Challenges | Insurance denial, underdiagnosis, workplace prejudice |
| Societal Influence | Public fear, discrimination, and growing awareness movements |
| Outlook | Integration of neuroscience, inclusivity, and cultural therapy |
| Reference Source | National Institutes of Health – The Stigma of Mental Disorders (https://pmc.ncbi.nlm.nih.gov/articles/PMC5007563) |
Psychiatry started to take shape by the 19th century, though not always with compassion. Physicians who believed that madness resulted from unbalanced fluids, like Benjamin Rush, who is regarded as the father of American psychiatry, practiced purging, bleeding, and blistering. Others, such as Dr. Henry Cotton, took this reasoning a step further and removed intestines, tonsils, and teeth in an attempt to “cure insanity.” Despite the unavoidably tragic outcomes, these techniques were hailed as scientific. It was a time when ignorance passed for advancement.
The twentieth century, the era of electricity and daring surgery, followed. While lobotomies provided what medical professionals referred to as “hope through precision,” electroconvulsive therapy (ECT) promised to alleviate depression. This purported remedy was transported throughout America by Walter Freeman’s traveling “lobotomobile,” where thousands of people had surgery with an icepick and a hammer. At the time, people confused desperation with creativity. Freeman acknowledged that patients lost their “sparkle” following the procedure, which is a terrifying understatement for lives that have been irrevocably changed.
Psychiatry entered a period of reflection as the decades passed. Dr. Lieberman and others documented how attitudes toward human behavior were shaped by psychoanalysis, which dominated much of mid-century thought. Sigmund Freud’s theories led to both fascination and overreach, with therapists treating homosexuality as deviance and diagnosing everyday sadness as neurosis. It was classified as a “sociopathic disturbance” in the DSM-I, the defining manual for psychiatry. That label wasn’t taken off until 1973, which is a very late correction for a science that is based on empathy.
Soon after, there was a backlash from the public. Thomas Szasz, a Hungarian-American psychiatrist, asserted in his 1961 book The Myth of Mental Illness that psychiatric diagnoses were only social control mechanisms. Although his opinions caused division in the medical community, they forced it to consider its own procedures. Despite its radicalism, the anti-psychiatry movement compelled reform and openness. Even though it brought up new issues with dependency and overprescription, medication-based treatment started to change mental health care by the late 20th century by providing a new kind of stability.
However, stigma persisted—the ghost that psychiatry was unable to eradicate. According to the National Institutes of Health, people with mental illnesses are not given the same social value in any culture. Bipolar disorder and schizophrenia, which are frequently depicted in the media using exaggerated clichés, continue to cause anxiety. Films that depict violence associated with mental illness serve to bolster fear. Celebrities like Demi Lovato and Carrie Fisher challenge this fear and inspire compassion when they open up about their diagnoses. These instances are incredibly successful at changing public opinion.
Another layer is added by cultural context. Curses, possession, or divine punishment are some of the ways that mental illness is still perceived in some places. Despite its age, this belief is reminiscent of Western history, when people with mental illnesses were viewed as sinners rather than victims. The persistence of such thinking demonstrates the slow evolution of human empathy. This resistance is also demonstrated by language; commonplace terms like “crazy,” “psycho,” and “maniac” perpetuate outdated stereotypes in everyday speech.
The media has played a dual role. While there are significantly fewer human-centered stories, sensational coverage has historically heightened fear. Personal contact, according to researchers like Wulf Rössler, is still the most remarkably effective way to lessen stigma. Fear is turned into understanding when one knows someone who has a mental illness. It is a tiny but incredibly effective step that is far more effective than policy alone at eradicating prejudice.
New movements in the last few decades have rethought mental health from a culturally aware perspective. Initiatives that combine therapy with identity, faith, and community have been spearheaded by individuals such as Dr. Hooman Keshavarzi and Dr. Igda Martinez. Their methods are especially creative, assisting underserved populations in viewing therapy as familiar rather than alien. Treatment for mental illness becomes more relatable and restorative when such viewpoints are used.
Online activism has gained unexpected vigor in the modern era. Younger generations are sharing experiences that were previously kept quiet on platforms such as TikTok. Despite their seemingly informal nature, these digital confessions have a significant impact and transform vulnerability into connection. The shift from clinical detachment to emotional honesty in the language of mental health is encouraging. People break down barriers that were previously reinforced by institutions by using shared stories.
However, there is still a gap between stigmatized illness and socially acceptable distress. Schizophrenia is still taboo, but interview anxiety is relatable. The way society compartmentalizes pain is demonstrated by this selective empathy. But healing necessitates inclusion. It is necessary to view the spectrum, not the distance, between mental health and illness. The way that communities support one another—through empathy rather than avoidance—may benefit greatly from that understanding.
The field of psychiatry itself is still undergoing rehabilitation. As Lieberman admits, stigma itself—rather than ignorance—is the biggest obstacle facing the field. And that’s possibly the most timeless truth of all. The transition from asylums to acceptance has been excruciatingly slow, but it has significantly improved thanks to human compassion, scientific rigor, and collective awareness.
