I was in New York City, spending time with my partner after not being able to see him for over a month. We were having a great week; so good to spend time with the person you love. We were excited for the big Halloween party he was planning for this weekend (today). I loved watching him light up as he was talking about all the decorations he had in mind, the fantastic food and drinks he was going to prepare for everyone, the costumes we were going to wear, and the fun we were going to have with all of our friends. Throughout the week, he would come home from work and keep spreading the spiderwebs across the kitchen and the living room, testing out the black lights to see how they’d work, and finish making last-minute touches to his plans. It was beautiful and I loved the memories we were making and sharing together.
It was all going as we had in mind until I sent a text Thursday morning and he called me. I was in the airport, crying. I said I had to go home. I booked a flight that morning and it was about to take off. He wanted me to stay, but understood if I had to go. For some reason, my mind told me I needed to leave.
I got on the plane and cried the whole flight home.
In the days since, I have mentally terrorized myself, being so angry and upset at myself for needing to leave, putting myself down, thinking how much hurt I have brought to my partner, how I didn’t communicate effectively, and how I just overall place so much stress onto our relationship. I don’t understand how or why he still wants to be with me after causing him so much pain like this. I’ve been imagining putting myself into his shoes and how it must feel. I feel awful, like all I want to do is punch myself again and again.
And the reason I needed to leave New York and to come home? To take care of my mental health.
Throughout each episode of depression I endure, I look to gain something from which I can learn and grow. After I make it each each depressive episode, no matter how difficult it might be, I take some time to reflect upon how this episode was, including potential factors that might have led up to the episode, instances that occurred during the episode, and things that might have helped get me through the episode as well. I like to think of it as turning my mental health experiences, my depression into my own little science experiment and case study, if you will.
In recent instances, one of the biggest trends I have been noticing within myself is the self-stigma that I attach to my own mental illness and to my own recovery.
Through this, that got me wondering: What is self-stigma like with others who have mental illnesses? How does it affect our own perceptions of ourselves and how does it affect our treatment and recovery?
So, I decided to do some investigating.
First, I would like to define self-stigma. The way I see it, self-stigma is the shame individuals who have mental illnesses place on themselves as a result of their mental illness and the behaviors that occur from their illness.
Others define it this way:
People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result.¹
To experience self-stigma, the person must be aware of the stereotypes that describe a stigmatized group (e.g., people with mental illness are to blame for their disorder) and agree with them (that’s right, people with mental illness are actually to blame for their disorder). These two factors are not sufficient to represent self-stigma, however. The third A is application. The person must apply stereotypes to one’s self (I am mentally ill so I must be to blame for my disorder) 21. This perspective represents self-stigma as a hierarchical relationship; a person with mental illness must first be aware of corresponding stereotypes before agreeing with them and applying self-stigma to one’s self.²
Self-stigma is a burden that is prevalent among people with mental illness, says Robert Lundin, a Chicago-area mental-health worker and writer who began having delusions in his 20s and was later diagnosed with schizoaffective disorder, a combination of schizophrenia, mania, and depression. “The diagnosis [and subsequent hospitalization and treatment] left me with a very difficult feeling of failure,” he recalls. “Your life does not go well at all when you get these illnesses.” But, he adds, “there would be no stigma if I had diabetes or heart failure.” Lundin is, in fact, a colon cancer survivor, and has no feelings of stigma associated with having had cancer.
Self-stigma occurs when patients agree with and internalize social stereotypes. It tends to affect them in three ways, says Amy Watson, PhD, assistant professor of the Jane Adams College of Social Work, University of Illinois at Chicago:
•Patients often think that their illness is a sign of character weakness or incompetence.
•Patients develop feelings of low self-esteem and become less willing to seek or adhere to treatment.
• Patients anticipate that they will be discriminated against, and to protect themselves they limit their social interactions and fail to pursue work and housing opportunities.³
As you can see, these explanations of self-stigma are all pretty heavy. There’s a lot of profound depth in each reference. Something that began to occur to me when doing this little bit of research (which I will continue to keep going with) is that the effects of self-stigma are likely greater than we might realize.
Looking back on my own experiences with my mental health, I deeply believe this to be true, that self-stigma has affected me more than I have realized throughout my history. The further and further I investigate this, I see how my own stigma toward and against myself and my mental health has affected my life, my friends, my family, my loved ones, and my partner.
Here are some examples:
- I say sorry for everything. Everything. I am aware that I do, yet I continue to do so. I apologize for not having enough time in the day to get everything done. I apologize for someone else having a difficult day. I apologize for the troubles that are going on in the world. No matter what might be wrong – in any slight manner – I take the blame and put it on myself. I am currently in counseling for my depression and my counselor (she’s amazing) giggled, saying that I walk around hunched over with the weight of the world on my back and if there is any blame I can take on, I will make sure to find some room to bring it along with me.
- I am so damn afraid of what people think of me. So damn afraid. Every action I take is generally for someone else, to make someone else happy because I’m afraid of what they’d think if I did what I wanted to do. I have this endless desire to please everyone. And if that means that I need to live the way others want me to, then by all means, that’s what I’ll do.
- I can’t accept compliments and I can’t accept love. When someone compliments me or says they love me, I think they’re lying. How can they love me? Don’t they see the mess that I am? They must just be being polite. I believe I’m destined to be alone. And so I project these beliefs into my reality.
When I analyze it more and more, I can see how self-stigma is at the root of many of these issues. Because I beat myself up over my mental health, because I stigmatize myself over my sexual orientation and the dreams and goals I have for my life, I need to apologize and take blame, I need to be afraid, and I need to continue pushing love away. Giving into these actions and emotions is giving my self-stigma all the more nutrients to grow and it loves to feed off this.
This is why me getting on that plane to head back home was so important. It was me taking control of myself back from my self-stigma. It was me doing what I needed to do. I recognized the city was becoming a trigger for my anxiety and depression – the sheer volume and immense nature of the city made me feel too small, so I collapsed into my negative emotional place, amping up the “sorry’s”, the apologizing, the self-shame, and the self-stigma. In that moment, getting on that plane was a transformative act of self-care and while I absolutely could have went about it more effectively (i.e. communicating with Jeremiah), the first step of recognizing my internal shame was a big one.
So, where do we go from here? Well, that’s the beauty and the motivation I am blessed to currently have. I want to overcome this, erase this self-stigma from controlling my life, and so it begins with me. It begins within ourselves. As mental illness is such an individualized experience, I anticipate there might be methods that work better for some than others, but this is my game plan:
- Begin recognizing how my self-stigma manifests in my life
- My relationships with my loved ones (thinking no one loves me because of my mental illness), my relationship with myself (thinking I am not worthy of being loved because of my mental illness), etc.
- Getting to the root cause of issues
- Researching self-stigma further, understanding how I allow it to control my actions, then being active in making a positive change
- Expressing my thoughts and feelings with my loved ones, knowing they love me for who I am; accepting the thoughts and feelings I have within myself
- Holding myself accountable
- Knowing that I want to change, I need to improve, and the good that will come of it
- Not being afraid to seek help – and to ask for it
I’m sure it won’t be an easy road, but I am confident it can get better. With the help of mental health professionals, community, and our own selves, we can begin erasing self-stigma in ourselves. Once we do this, I believe we can erase the stigma facing the mental health community as a whole.
I am so incredibly blessed for Jeremiah, for his patience and understanding, and for his never giving up on me. Even when I’m at my lowest and even when I do things that hurt, he loves me through it all and falls in love with me a little more each time. I couldn’t have asked for a better partner and I couldn’t have been more blessed.
I will make it up to him one day. I know I will, just in this moment, real quick, I gotta fix this issue inside. I know he is at my side and I’m at his. And through it all, we march on together.
I’ll end this post with one of my favorite quotes, a reminder and message of encouragement for all of us struggling with mental illness and all of those who love us through it:
It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.
Theodore Roosevelt, THE MAN IN THE ARENA
Excerpt from the speech “Citizenship In A Republic”
delivered at the Sorbonne, in Paris, France on 23 April, 1910
I love you.
Here are some additional tremendous resources on self-stigma:
If you or a loved one are facing suicidal thoughts or ideation, please call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).