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The Last Taboo: Breaking Down the Stigma of Depression

Thoughtful man sitting on sofa in living room, portrait

The ignorance about mental health issues that continues to exist among otherwise intelligent individuals is perplexing. In today’s modern world, with continuously increasing tolerance for human differences, many of yesterday’s taboos have become today’s facts of life. Issues from racism to sexual identity have been stridently tackled and, while much work remains to be done, we have come miles. The recent Supreme Court ruling regarding gay marriage is a perfect example of how far we have come.

However, there still remains what some have referred to as “the last taboo.” Namely, depression continues to be one of the most stigmatized mental health issues out there. This is ironic, given that by the year 2020, according to the Centers for Disease Control and Prevention, depression is estimated to be the second most common health problem in the world. Further, because of the unjustified stigma that still exists, a large percentage of those who experience depression will not be treated.

So, what is the missing piece to this puzzle? Why is the message not resonating with the greater population? Why is stigma still so prevalent in our society? As mental health practitioners and social advocates, what can we do to eradicate this social dilemma?

When it comes to obtaining treatment for medical ailments as benign as the common cold, people don’t think twice about running to the doctor, or the acupuncturist, and spending the money on treatments to feel better. So, why do so many who suffer from depression continue to hesitate, despite all of the treatment options available?

In addition to the externalized stigma or discrimination toward those with mental health issues that exists in society, there comes internalized stigma, or self-shame. This makes the experience of mental health issues all the more devastating. Many times, it is the internalized shame that stops people from acknowledging psychological problems and receiving treatment, since many see it as akin to admitting that they are weak or damaged in some way.

According to the U.S. Preventive Services Task Force, a panel that sets treatment guidelines for primary care physicians, an estimated 6% of teens in the United States suffer from clinical depression, yet most go undiagnosed and, therefore, untreated. This information alone strongly indicates a dire need to raise awareness.

But where do we start?

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How about with the media? Instead of programs like Criminal Minds perpetuating the stereotype of schizophrenia as a violent disease, let’s have some intelligent programming that humanizes mental health issues. What Will and Grace did for sexual identity, perhaps the same can be done for depression. Since we are a society so attached to the media, why not take advantage of the opportunity to educate people?

We can also begin in our school system, making mental health education a part of the curriculum. As has been discovered in other areas such as sex education, knowledge can be a powerful tool in prevention. Why is it that when we learned about Abraham Lincoln in social studies, or Walt Whitman in literature class, we learned almost everything about them except the fact that they experienced psychological problems? Why were these facts omitted from the textbooks and class lectures? We need to make stigma a thing of the past and teach our future leaders of tomorrow that it is okay to recognize, and seek treatment for, the experience of clinical depression and other mental conditions.

Before we begin with the masses, let us also first look at ourselves as therapists and mental health caregivers. We must look at our own core beliefs and biases, which can directly affect the work we do. We may be unknowingly perpetuating the stigma of depression and other psychological issues. Change must begin within the mental health community. To change others’ minds, we must first change our own.


  1. Depression statistics (2008). Retrieved April 3, 2009 from: http://depression.emedtv.com/depression/depression-statistics.html
  2. Panel: All teens should be tested for depression. (2009). The Associated Press. Retrieved from: http://www.msnbc.msn.com/id/29945008/

© Copyright 2013 by Allison Abrams, LCSW, therapist in New York, New York. All Rights Reserved.

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  • henry August 21st, 2013 at 8:54 PM #1

    being depressed or being affected by any other problem with mental health is NOT a crime.I agree that there is internal bias against this too.why I’ve had it myself too-until I learnt about how silly it was to have such a bias.no person would blame him or herself if he or she fell ill or had a physical health issue would they?

    then why do it for mental health.not only does letting to of the bias help with diagnosis and treatment but also sets you freein ways that you’d ever have imagined.try I and see he difference!

  • Izzy August 22nd, 2013 at 3:51 AM #2

    Are you sure that there is still a very large stigma about depression?
    I mean, it seems like all of my friends have been treated fro depression at some point and no one seems to be that hesitant to talk about it.
    It almost seems as if in the circles I am in, you are the different only if you HAVEN”T gotten therapy at some point!

  • Allison Abrams, LCSW August 22nd, 2013 at 9:50 AM #3

    Izzy, yes, you are right- stigma has definitely lessened over the years- thankfully! And, it has become more and more accepted to be in therapy, especially in larger, metropolitan cities such as NY. However, yes, stigma still does exist out there, especially within certain cultures. As I mention in the article, although we have certainly come a long way, there is still work to be done.

  • Stella August 22nd, 2013 at 10:47 PM #4

    Thank you for this piece, Allison! I also think it’s necessary to note what might be happening culturally/socially that depression rates are ever-expanding. With all this supposed “social connectedness,” perhaps we are lonelier than ever.

  • Allison Abrams, LCSW August 23rd, 2013 at 8:58 AM #5

    You bring up a great point Stella. So called ‘social media’ certainly does not seem to be making people more social, but, and as you say, lonely and perhaps more isolated and depressed..despite the illusion that we are being more social. Nothing can replace real human contact.

  • Izzy August 23rd, 2013 at 10:32 AM #6

    Allison you make a great point with that. I do live in a larger city, and I think that you are right that there are things that are accepted where I live as the norm that might be looked on as weird or definitely out of the box in other areas of the country. I sometimes think that my friends are trying to keep up with each other as to who can outdo the other, not that they don’t have anything wrong with them, but that they will be the odd man out if they haven’t at least expereinced this or that. Regardless, I don’t think that therpay is a bad idea for anyone at least once in his life, and hey, accepatnce and understanding has to start somewhere right?

  • claira August 26th, 2013 at 4:07 AM #7

    There was a time in my life when I would have never even thought about telling friends or family that I was receiving treatment for depression. I don’t really have those same qualms today that I may have 20 years ago, but it is all about a process of acceptance with myself. Until I am ready to accept that this is aprt of me and who I am then how am I to expect that others will accept this either?

  • Allison Abrams, LCSW August 26th, 2013 at 9:16 AM #8

    Claira, you are absolutely right- self-acceptance comes before anything else. Thank you for sharing!

  • Cassandra September 23rd, 2013 at 12:24 PM #9

    What kind of depression is when you think all the time about self harm or suicide?iam always hitting my head when I get mad or sad
    I dont really know what kind of depression i have and I am very confuse
    Any aswers that would help thank you.

  • Allison Abrams, LCSW September 24th, 2013 at 9:58 AM #10

    Cassandra, if you are experiencing thoughts of suicide or self-harm, I recommend that you seek professional help as soon as possible, call 911 or visit your local emergency room. You may also call the National Suicide Prevention Lifeline at 1-800-273-TALK. To answer your question, suicidal thoughts and thoughts of self-harm are serious symptoms of depression. However, your diagnosis or “type of depression” would have to be determined by your treatment provider. I hope that you do seek treatment as soon as possible.

  • Rebecca April 27th, 2014 at 11:59 AM #11

    I am a graduate student studying counseling and development to ultimately practice as an LPC (licensed professional counselor) in the community agency setting. I also have been diagnosed with depression and generalized anxiety disorder. I struggle with my depression daily. My family and friends are all aware and supportive of my depression and anxiety. However, there are many times I feel as though people see my depression instead of my person as what defines me. There are times I feel others view my depression as shortcoming as far as my ability to function personally and professionally in my life. So, although I feel supported and excepted as far as being diagnosed or “labeled” with depression and seeking help for it, the way in which stigma most affects me concerns the way others perceive someone who is struggling with depression in daily life. That being said, yes, I believe that the stigma surrounding seeking help for depression has come a long was, but until our society truly understands depression and how it manifests in every day life – that it’s not a disability, those struggling with depression may still experience a level of loneliness and feelings of inadequacy. It is up to mental health professionals, the media, and other mediums that have the power to shape/influence our culture and cultural perceptions about the subject to help others truly understand the all encompassing nature of any mental health “disorder”. Individuals who struggle with mental health challenges can still be healthy, functioning, and contributing members of our society. My depression does not define me, just as my allergies don’t define me. Educating our society and initiating a paradigm shift with respect to our cultural understanding of mental health issues is very important, in my opinion, for helping those of us who may struggle with these issues to feel comfortable on a day to day basis to manage and assist in their own acceptance of living with depression. Thank you for writing this article!

  • Kellie September 20th, 2014 at 9:12 PM #12

    I have been severely clinically depressed with anxiety issues. I see a psychiatrist every three months for med checks. I was seeing a counselor on a weekly basis but it got to the point where I couldn’t afford the sessions anymore with my insurance co-pay. And next year our insurance is cutting even more options and I’m not sure I will be able to afford my psychiatrist and meds. My generation still carry’s a stigma with depression. Most of my friends don’t even know about my depression and anxiety. They think you should be able to pull yourself up by your bootstraps and get over it. Society still has a very long road ahead to get people to understand depression. In my town, a new patient has to wait at least three months to even get a first appointment with a psychiatrist. There is a shortage of psychiatrists. Something needs to be done to get more doctors in this field.

  • Mick November 5th, 2014 at 5:18 AM #13

    Hi Alison (and anyone else reading this)

    I am pulling out of the Big D for what hope is the last time, after and almost 30 year circus of mis-diagnosis, sloppy treatment and an overwhelming sense of shame. And I now realize how stupid I’ve been – about the shame and sense of stigma, I mean.

    And I thinks it’s time to end this.

    I propose that we (ex-?)depressives need to get out of the closet, to steer society towards realistic accpetance of our existence, our fortitude and our value as human beings.

    In short, that we learn from the experiences of the GLBT world; the activism on behalf of the mentally handicapped; the racial integrators, and all the others that have fought to engineer a more sensible society.

    I have no idea how to go about organizing such a thing so, as a first step, I reach out to you to see how sympathetic you might be to such an initiative, who you might know who might be recruited with a knowledge of effective tactics and strategies. You get the idea.

    Any interest?

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