Netflix recently released “Diagnosis,” a seven episode series that follows a New York doctor and author as she searches for answers to eight different medical mysteries.
Dr. Lisa Sanders thoroughly reviews the medical records of patients with life-altering and undiagnosed illnesses before writing a New York Times article and asking for the help of people everywhere, whom she refers to as “the crowd,” to find the right diagnosis and treatment. There is no doubt that the patients profiled are struggling and the outcomes are not always what they had hoped for. It is compelling television. However, as a person with a mental illness, something else stood out for me — the power of stigma.
There are three episodes that deal with mental illness: “A Question of Trust,” “Déjà Vu” and “Paralyzed,” which follows the story of two patients. In the sixth episode (“Déjà Vu”), the featured patient, Matt, struggles with fainting and his heart stopping — terrifying. Someone in the crowd suggests that stress may play a role in some of his symptoms. He seeks out therapy and both his physical and mental health improve, which demonstrates how interlinked our mental and physical health are — something that is emphasized in this episode. In the other two episodes, which follow patients Lashay, who experiences constant vomiting, and Ann, who has spells of paralysis on her right side, viewers are offered a different perspective. Both Lashay and Ann receive diagnoses from the crowd that Dr. Sanders believes are a good fit: rumination syndrome for Lashay and functional disorder for Ann. While neither of these diagnoses are psychiatric in nature, both patients somehow heard, “It’s all in your head.” Dr. Sanders goes out of her way to convince both Lashay and Ann that she believes their illnesses are physical in nature and neither diagnosis is marking them as having a mental illness. In the end, neither Lashay nor Ann sought further testing or treatment for the very likely diagnosis they received.
These episodes, the way each patient reacted and the way Dr. Sanders tied herself in knots trying to convince Lashay and Ann they were not being diagnosed as “mentally ill,” confirmed a few things to me.
First, society still differentiates physical and mental illness. Physical illness is legitimate, nothing to be ashamed of and deserves prompt attention, diagnosis and treatment, and it can affect anyone, from athletic, attractive teenagers (Lashay), to intelligent, environmentally conscious New Yorkers (Ann). On the other hand, to have a mental illness means you’re “crazy,” “nuts,” and there must be some kind of character deficit, because it most certainly doesn’t affect athletic, attractive teenagers or intelligent, environmental conscious New Yorkers. At least, that is what these two episodes of “Diagnosis” seem to show. Both Lashay and Ann decide to continue living with debilitating symptoms instead of seeking treatment for conditions that someone, somewhere made sound like they were mental illnesses.
I know 17-year-old me would probably have been offended if you told me I would be diagnosed with bipolar disorder. I had a stable, loving upbringing. I was physically healthy and never drank, smoked or did drugs. I excelled in school and had a group of close friends. I was studying chemical engineering at a top Canadian university when my symptoms started to tear apart my life. Twenty plus years ago, I believed mental illness couldn’t touch a person like me. I was proven very wrong. In 2019, it is disappointing to see that message continue to broadcast in the media, because we know that mental illness does not discriminate and can affect people of any age, ethnicity, socio-economic status, level of educational attainment, etc.
According to the Canadian Mental Health Association, “In any given year, one in five people in Canada will personally experience a mental health problem or illness.” Consider 10 people in your life, friends, family, co-workers. Statistically speaking, two of them will experience a mental health problem or illness this year.,
Second, the medical community still differentiates between physical and mental illnesses. While there are some passing comments about the connection between our brains and the rest of our body, the tension in these two episodes exists around Dr. Sanders’s ability to find a way to convince Lashay and Ann that their diagnoses aren’t psychiatric, so that maybe they will seek treatment. She wants them to know that she doesn’t think “it’s all in their heads.” Here, Dr. Sanders makes mental illnesses, illnesses that are by definition, “in your head,” seem shameful. It’s also a huge missed opportunity for Dr. Sanders and others working on the show to dispel some of the myths and misinformation about mental illnesses.
Finally, “Diagnosis,” and its handling of acutally-not-psychiatric-illnesses, proves that mental illness is still hugely misunderstood. When the phrase “all in your head” is used, it assumes that mental illnesses, and their very real physical symptoms, are made up. Ask a person who struggles with anxiety or panic disorder if they are just making up their heart palpitations, light-headedness, nausea and vomiting, and you would likely hear a stern “no.” Those physical symptoms are no less real because they came from a signal in a person’s brain and not a trip to a sketchy sushi bar. When someone with schizophrenia experiences hallucinations, they can be as intense as anything you or I can see or hear right now. And a person cannot just turn off the hallucinations by knowing that they are coming from their head. When I experienced hypomanic and manic episodes, I only needed about three or four hours of sleep a night for weeks on end. I wasn’t drinking caffeine or taking any stimulants. That energy was all from inside my head. But it was real. Our brains are the control center of our bodies. It makes sense that illnesses of the brain, a physical organ, can have physical symptoms. Sometimes the physical symptoms can be debilitating on their own. But mental illnesses are treatable. Treatment can come in the form or medication, therapy or behavior modification, similar to how conditions like arthritis or type II diabetes are treated. And treatment can take some time, again, the same as many illnesses in the rest of the body. People with mental illnesses can lead productive, positive and “normal” lives.
But they have to first face the stigma that comes with a diagnosis of a mental illnesses and treatment. And that alone can prevent a person from receiving the help they need. Sadly, I believe shows like “Diagnosis” only perpetuate this stigma and make it more difficult for those living with mental illnesses.