Everyone should have the right to decide when and with whom to disclose health problems. In some cases, privacy can be both appropriate and desirable. There is a difference, however, between illnesses we choose to keep private simply out of personal preference and those that we feel we must keep private in order to preserve our social standing, our jobs or our legal rights. When we feel that we have to keep our illness a secret, as do many with psychological disorders, we are feeling the effects of stigma.
Plenty of illnesses, including HIV and hepatitis, can be stigmatizing. When it comes to mental disorders, however, stigma and shame can operate in a couple of unique ways.
- Those of us with common psychological disorders, especially depression and anxiety, frequently feel bad about ourselves to begin with. That’s one of the primary identifying symptoms of these illnesses. Therefore, stigma about mental illness feeds into our psychological symptoms, which can in turn worsen feelings of stigma and shame.
- Depression, anxiety and bipolar disorder can cause us to behave in ways that we usually wouldn’t. We might miss or break important appointments. We can be more irritable and impatient with our loved ones and treat them badly. We might drink more, take drugs, spend compulsively or engage in other obsessive behaviors. Often, we try to keep our worst behavior a secret from those around us. All of this exacerbates underlying feelings of shame and guilt and can cause others to judge us harshly.
When all of this is taken together, it is completely understandable if we want to tell no one about our illness. Unfortunately, trying to cope with mental illness without the help and support of others can hinder our recovery and keep us from getting care we might need.
The first step away from the negative feedback loop of stigma and shame comes in the form of information—information about how common psychological problems are, how effective treatment can be, and how likely it is that those of us with mental disorders will lead rich and fulfilling lives.
Another important step is seeking qualified help. Effective treatment—psychological, medical and social—makes a huge difference in terms of our symptoms and how we feel about ourselves. Receiving a formal diagnosis of a mental disorder might bring up feelings of stigma and shame. Some people fear that this forever marks them as different from everyone else, or that they can never lead a normal and happy life. This doesn’t have to be the case.
A diagnosis is a label that professionals use to help determine the proper course of treatment. The diagnosis, however, doesn’t define you. It defines the problem and how you and your doctor can combat it.
Telling people you trust about your problem will also help fight stigma and shame. This can start with your primary health care provider or your mental health care provider. Ultimately, sharing what you’ve been through with close friends and family, or with other people who have struggled with the same illness, can be both a freeing and healing experience. Disclosure must be approached cautiously, but it can be an effective tool not only to break out of isolation, but also to restore feelings of self-confidence.
Finally, freedom from stigma can also come from examining your life and values then figuring out how to overcome your limitations and give back to the world in a way that is meaningful to you. For some, this might mean spending more time with children or grandchildren, or helping friends and neighbors. For others, it might mean engaging in volunteer or church work. Still others find satisfaction and fulfillment in telling their story more publicly or in helping others who are struggling with mental illness. Ultimately, the more that people like us talk openly about our illness, the more that stigma will fade away—not just from our own lives, but also from society at large.
Last Revised: June 14, 2010