This post is going to do what it says on the tin, talk about stigma. However, it’s going to take an unexpected turn so don’t stop reading yet! Stigma is defined as a mark of disgrace associated with a particular circumstance, quality, or person, and people with mental health problems are often on the receiving end of it. Stigmatic beliefs about mental illness include us being “different”, unsafe, unpredictable, unreliable, unable to work, etc. We receive this stigma from a variety of sources, from family, friends, spouses, teachers, colleagues, managers, doctors, emergency services and the media. These people make up our wider society and it’s very difficult to be someone who is diagnosed with a stigmatised condition and then feel able to be open and honest about it like so many people and charities suggest when what we’re being asked to do often opens us up to unwarranted criticism, changed behaviour and damaging comments from people. Worse than this though, is the fact that stigma about mental illness is currently so ingrained in society that almost everyone within it has some sort of stigmatic belief, that they may not even be aware of but that will be affecting how they treat others or themselves.
So where am I going with this? I told you it was going to take an unexpected turn but it hasn’t yet. As you all know, I’m a campaigner against stigma and I regularly write and talk about my experiences of mental illness and do this with a great deal of openness and honesty in order to dispel some of the myths and misconceptions and put a face to mental illness so that people can see we’re not all murderers and that mostly we don’t pose any risk to others and any risk we do pose is to ourselves. I know all about the causes of mental illness, I’ve sat exams about diagnostic criteria, I’ve worked with patients with the most severe forms of these conditions and I know that mental illness isn’t anyone’s fault and should be treated in exactly the same way as physical illness is, with dignity, respect, belief, understanding and compassion. But, and this is a BIG but, I still hold stigmatic beliefs about mental illness. I’m not stigmatising towards or about anyone else. I’m very understanding about other people’s conditions, sympathetic of their struggles and can empathise completely with what they’re going through. And yet, I don’t extend myself the same courtesy. I consciously know that mental illness isn’t my fault, it’s not in my control and it’s struck me for exactly the same reason as any physical condition could, at random! But I believe, deep down, completely undeliberately, that it is my fault, that I’m somehow weak and failing and that’s the reason I’m ill or why I deteriorate sometimes. I don’t believe this about anyone else, when one of my friends deteriorates I’m the first person to stop them blaming themselves, to tell them it’s not their fault and there’s nothing they could have done to stop it, and yet, I somehow don’t treat myself in the same way.
Stigma is so ingrained in our society that no amount of studying, work, or experience has allowed me to let go of my most strongly held beliefs that this is somehow my fault. Part of this is from society, part of it is also from people who have specifically told me it’s my fault or accused me of faking it, exaggerating or attention seeking, or suggesting it’s my fault or in my control by telling me to just try harder, to think positive, to go for a run, or eat more fruit and veg, as if that’ll suddenly make my depression or anxiety melt away, and more insultingly, as if I’ve not tried all of those things and then some, to no avail! I strongly believe that societal stigma is starting to reduce, generally people are happier to talk about mental health, they’re starting to realise that these conditions are real, just as real as any physical illness, and that they’re out of our control. People who are mentally ill are starting to feel more able to blog about it, write a status about it, or reach out and ask for help when they’re really struggling. But I would guess that most of us, when we look really deep down, are still self-stigmatising. We still believe on some level that we’re different, that we’re weak, and that we’re somehow ‘less’ than others. No wonder our self-esteem is so often through the floor when our own internal monologue lets everyone else off (quite rightly too) and yet still blames us as the one person who is in control, attention seeking and not trying hard enough. I for one, spend hours wondering why and how I got ill, what I could have done differently, what it was I did wrong, what I could be doing now to make it better. This is a totally futile exercise because it’s not my fault and there’s nothing I can do other than weather the storm as best I can, and yet deep down inside my mind tells me that’s wrong and that of course there’s something I can do or change, if I just look hard enough.
Societal stigma might be starting to improve but self-stigma is still rife. I can’t imagine I’m the only one who feels this way but until now I’ve never really admitted it to anyone, or even myself. I’m sure most people wouldn’t believe that I’m not judging them or blaming them when I’m doing exactly that to myself, and all I can hope is that by writing this, those of you in my life who are mentally ill will believe that I am telling the truth and I have never and will never judge you or blame you for your conditions because they’re truly not your fault, no reflection on you, and completely out of your control. I know I’m a hypocrite. I know I’m a walking contradiction, in so many more ways than just this one. But it’s exactly the same as most of us who would console a friend who’d failed an exam but beat ourselves up mercilessly for the same thing. This is just like that, but a hundred times worse, because no amount of revision, retakes, or extra tuition will cause this to go away or be more in my control and for some reason, despite consciously knowing all of this, even from day one, 9 and a half years ago when I first became severely depressed, I have always believed it was my fault. I know that every person I’ve met who has depression, anxiety, an eating disorder, or any of the other hideous conditions that plague our minds, is a warrior. They’re the strongest people I’ve ever met. The kindest, most compassionate people who will put their own needs aside in order to help someone else out who’s having a bad day, just to see them smile again. They fight, so hard, every day, just to get out of bed, to get dressed, to smile and try to behave normally when everything inside them is giving up, questioning what the point is, and often planning multiple ways to end it all, all before breakfast! I do all of this too, but somehow in my mind it’s not enough, I’m still weak and it’s still my fault. I constantly feel like I have to prove myself, prove that I’m trying, prove that I’m actually too ill to work, prove that I’m not making this all up.
As a society we’re definitely on the up. We’re campaigning more, we’re standing up for people’s rights more, we’re better at supporting each other and calling out discriminatory and stigmatic media portrayals and behaviour. But as individuals, are we doing the same for ourselves? I’m usually the first person to stand up for mental health, to call people out when they ask ridiculous questions like “what have you got to be depressed about?”, “why don’t you just stop worrying?”, and “can’t you just try going outside?” but I still expect miracles from myself, unrealistic changes that are simply out of my control, and when these don’t happen I feel like a failure and tell myself that’s exactly what I am. Societal stigma is on its way out, it’s got a hell of a way to go, but it’s being shown the door, but self-stigma really needs a helping hand too. Until people like me aren’t constantly belittling ourselves, feeling “different”, telling ourselves we’re failures, weak, or to blame, we won’t truly release stigma from our society. And where do we get these beliefs from? Where is it we’re internalising them from? From society. From the media, and the people around us; those who mean well and try to chivvy us along with ‘helpful’ comments about trying a bit harder and ‘just’ giving this or that a go, from those who outright blame us and make us feel small and pathetic, to the media headlines that imply we’re all dangerous, erratic, killers who can’t be trusted with any responsibility and are just a burden on society and a waste of resources. Until society stops giving us stigma to internalise, self-stigma will still be rife because it’s easy to extend a compassionate hand to a friend when you can see that they’re ill through no fault of their own but when you’ve spent your whole life hearing that ‘people like you’ are inadequate, risky, and to blame, it’s all too easy to internalise that and compound the problem with symptoms that make your self-esteem plummet and suicide seem like a great option. It’s easy enough to see the truth when these conditions affect others, I know full well that none of my mentally ill friends are at fault or to blame, they’re just as much in control of their conditions as the friends I have with physical conditions. And yet, society has ingrained the stigma into me so well that I can’t currently turn that inwards and instead I constantly judge myself. Add to that, the fact that almost all mental illnesses are coupled with low self-esteem and self-confidence, as well as negative thought patterns, and you’re well on your way to thinking, and wholeheartedly believing, that this is no more than you deserve, this is happening because you’re an awful person and you deserve to be punished and to feel this way. Stigma feeds the very worst symptoms of mental illness, the doubt is already there because of your condition and then society reinforces that and tells you that of course you can’t be trusted and that you’re definitely worth less as a person now, your symptoms then ramp up a gear and use all of the societal stigma against you to prove that you are indeed a worthless, awful person, who’s to blame for all of their misfortune. This combination of societal stigma, self-stigma, and symptomatic low self-esteem and negative thoughts are like being tortured, from the outside and the inside. There’s no let up. Until one stops, the other can’t possibly stop, and our symptoms aren’t about to give us a break and tell us we’re awesome and blameless so society will have to change first because well people are our best hope at reducing this quickly and reminding us of the truth, that this isn’t our fault, and the last thing we need to be doing whilst plagued by these illnesses, is blaming ourselves.
So there you have it: Stigma – My Dirty Little Secret!