But for me it’s not simply the stigma that is perpetuated, but also the glorification of mental illnesses that creates problems, e.g. *A Beautiful Mind*, *Girl Interrupted*, *Fight Club*, *One Flew Over the Cuckoo’s Next* and a slew of other movies, that while perhaps drawing needed attention towards mental illness in general, makes it even more difficult for people to properly recognize and respect mental illnesses in people who are still trying to resolve within themselves whether or not they are ill as well as figure out how to go forward with it all. When people around a person refuse to acknowledge even the possibility of mental illness simply because you’re not bathed in lethargy, writhing on the floor, freaking out and screaming, talking to hallucinations, catatonic, etc., it hurts the person just as much and can completely reverse any progress that might have been made.

How is it that the media and entertainment industry judge it to be ok to refer to people with these sorts of problems in such an uneducated, simplistic and stigmatising way? It would never be tolerated with any other minority group.

I once requested a disclosure under the freedom of info act from ofcom regarding the number of complaints about stigma against people with mental health problems (and how many were upheld). Can’t remember the exact stats but as you’ll guess, very very few complaints were taken seriously. Would be good to compare against complaints re racism or sexism…

I fear that reducing advertising would not help, increasing the minimum drinking age would help and maybe a reduction in the alcohol level in the beer would also help. All this ignores the prevalence of the happy hour and spirit based drinks clearly aimed at the young – this is an area where advertising needs to be more rigorously regulated.

With you being from America this gives me the perfect opportunity tell you of (hypothetical) situation that well illustrates the difference in drinking attitudes in the USA and UK:

In the UK if you say to your friend that you’ll have a lemonade, your friend will often say, ‘don’t be silly, I’ll buy you a pint’. Whereas in the USA they might say, ‘that’s a good idea, I think I’ll have one of those myself’.

Thanks for the compliment!

Do you really think that banning alcohol ads would help? I don’t know much, but it’s definitely different from the drinking culture in America. Not as many people (well, over the age of 21 or once they’re out of university anyway) seem just so properly enthralled and enamored with drinking itself, as if it’s a crucial part of identity.

Oh, and I’ve been reading your blog since the winter, can’t really remember how I stumbled across it. I really do hope you keep it up for a long time to come.

James Warner has done a bit of work looking at this issue. I found this in the BJPsych (Gledhill et al. 171 (3): 228-232) but i also remember reading another article by him but can’t quite locate it.
There is an appreciable patient population that would like us to dust off the mothballs. I might move over to the continent in future - would i be seen as a maverick not wearing a white coat?

http://www.cnn.com/2008/HEALTH/conditions/09/01/sex.addiction/
When sex becomes an addiction
By Elizabeth Landau
CNN

(CNN) — When actor David Duchovny made headlines for voluntarily entering rehab for sex addiction, fans of the “X-Files” star were left wondering: How can someone become addicted to sex?

It turns out sex addiction, also called compulsive sexual behavior, operates somewhat like a gambling compulsion or alcoholism: It’s about devoting your free time to a behavior that you cannot stop, even if you damage relationships or prompt other negative consequences. Examples of addicting sex behaviors include extensively using pornography, having affairs, sleeping with prostitutes, and masturbating excessively, to the point where such behaviors get out of control.

If you think it’s just about being horny, think again. For many addicts, sex becomes a way to numb out painful feelings, kill time or stop feeling lonely, said Kelly McDaniel, licensed professional counselor in San Antonio, Texas, and author of “Ready to Heal: Women Facing Love, Sex and Relationship Addiction.”

“Most people I talk to get to the point where they don’t even like sex,” said McDaniel, who has no connection to David Duchovny and did not speculate about his specific situation.

Sex addiction is estimated to affect 3 to 6 percent of adults in the U.S., according to the Mayo Clinic, but the American Psychiatric Association has not classified the condition in its diagnostic handbook.

The Internet, providing endless opportunities for porn-watching and cybersex, has fueled a surge in cases of sex addiction, experts say.

“We’re seeing it with epidemic proportions now, particularly with regards to cybersex,” said Mark Schwartz, psychologist and former director of the Masters and Johnson Institute in St. Louis, Missouri. “There isn’t a week that goes by where I don’t get two calls” about sex addiction.

Therapists have recently seen more women with the condition in connection with Internet porn, which has become a “gender-neutral” addiction, McDaniel said. Before, female sex addicts generally tended to have affairs or become sex workers.

Experts acknowledge that people who have affairs or use pornography are not necessarily sex addicts. Such pastimes form an addiction when they generate negative consequences for a person’s relationships, take over free time and become impossible to quit.

Where does it come from?

About 80 percent of sex addiction cases have sexual abuse or emotional trauma in their backgrounds, said Doug Weiss, therapist and executive director of the Heart to Heart Counseling Center. Schwartz also noted that huge numbers of people coming forward as sex addicts have been abused, assaulted or raped.

“When you have abuse in your background, you’re less likely to trust people, [and] you’re more likely to turn to something like sex addiction as a manifestation,” Schwartz said.

Feelings of neglect as a child — whether from divorced parents or parents who both worked and didn’t spend a lot of time with their kids — may also lead to sex addiction, Schwartz said.

Research into the neuroscience of sex addiction has not been conclusive, the Mayo Clinic said. Naturally occurring chemicals in the brain such as dopamine and serotonin do contribute to sexual functioning, but it’s not clear how they are related to sex addiction. McDaniel said these two chemicals are lower in the brains of children who have suffered abuse, which may explain why some of them use their own bodies — or, in other cases, food — to increase dopamine and serotonin levels.

For many people, especially women, sex addiction occurs in tandem with another problem such as an eating disorder, drug or alcohol addiction, McDaniel said.

A lot of teenagers develop their sexuality with pornography and then find that relational sex isn’t as satisfying, said Weiss, who also called sex addiction a “growing problem.” He said extensive exposure to pornography alters

How does treatment work?

A good treatment center will review the reasons why the addiction has come about, along with the brain chemistry of it, McDaniel said. A premier rehabilitation facility would have a combination of individual and group therapy, 12-step support, and possibly psychiatric medications such as antidepressant medications if necessary.

Withdrawing from compulsive sexual behaviors for an addict is very similar to withdrawing from cocaine, McDaniel said. An addict will go into withdrawal, and without a treatment program, it’s tempting to replace sex with something else, such as food or alcohol.

“Treatment is long-term, and it’s not easy,” McDaniel said. “I really recommend that a woman or a man find someone who’s trained and understands that sex addiction is a brain disease and does not further the shame that comes with this disease.”

Unlike drugs or alcohol, the goal of sex addiction therapy is usually not abstinence but rather learning to have sex in a relationship, experts say. Similarly, someone who recovers from an overeating disorder does not stop eating entirely but learns how to manage diet.

Marriage counseling often becomes part of the treatment, Weiss said.

What’s after recovery?

Weiss considers himself a former sex addict, having recognized his problem in his early 20s. Women weren’t making him happy; he was using pornography and felt “in conflict” about it.

Now, he runs resource Web site for recovery at sexaddict.com, along with three-day intensive workshops to jump-start recovery for sex addicts.

Weiss said he’s proud of Duchovny for voluntarily seeking help, apparently without prodding from press reports or lawsuits.

“This kind of person who decides to get recovery for themselves without getting exposed” is “likely to get better,” he said. “People who voluntarily get better have a much better chance of staying well.”