Eradicating Shame and Stigma: We Still Have Work to Do

walking across road with shadow“Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.” Anyone who has struggled with mental health would likely agree that philosopher Kahlil Gibran very well could have had mental health in mind when he wrote those words, for they are certainly apropos.

Often, out of pain, one is forced to grow and to change. Remaining static is not an option. One who has fought his or her way out of the debilitating abyss of depression or the paralysis of anxiety, or any other affliction of the mind, and came out on the other side can truly understand the meaning and the joy of being free from its grip. Further, such a person often has the character and depth of soul of one who has been forced to fight against the tides of societal stigma and, for some, self-shame.

In my last article on the topic, The Last Taboo: Breaking Down the Stigma of Depression, I was touched by the comments and feedback from individuals throughout the country with whom the material seemed to resonate. Many shared their own stories of walls they continuously come up against, both externally and within, along their paths toward mental health. Others insisted that the topic is outdated, that stigma is a thing of the past, and that mental health is no longer a taboo subject. How wonderful it would be if it were universally true.

It is true that in large metropolitan cities such as New York, some would consider it to be in fashion to be in therapy. I recently heard a colleague describe the use of antidepressants among New Yorkers as akin to being on antibiotics in its ubiquity. The point being it is becoming more and more accepted to seek treatment, whatever form that may take. However, this is unfortunately not the case in other parts of the country and certainly the world. In many cultures, the idea of seeking out psychological help, whether seeing a therapist or, heaven forbid, taking medication, is looked upon as a sign of weakness—and for the more ignorant or simply uninformed, a sign of being “crazy.”

On the sometimes controversial topic of medication, after witnessing so many lives being saved physically and spiritually with the help of medication, it continues to bewilder me when this is questioned. Do we live in a society of overconsumption and overdependence on pharmaceuticals? Yes. Are there more people reliant on medication than possibly needed? Perhaps. Should this discount the thousands of people throughout the decades whose lives have been improved or saved by medical science? An emphatic no! When diagnosed with diabetes or a heart condition, for example, most would not give a second thought to taking insulin or other appropriate medication that will improve the quality of life and quite possibly the length.

The approach to treating mental health issues should be no different. More often than not, a physiological or chemical imbalance is to blame. Sometimes it is an early trauma or traumas. Often it is a combination of both. Never is it the fault of the individual, and seeking help is not a sign of weakness. This is why stigma—internal as well as societal—needs to end.

In honor of the recently completed Mental Health Awareness Month (May), my advice to anyone struggling with less-than-perfect mental health (and really, who isn’t?) is, rather than surrender to its pull or view a diagnosis as a life sentence, to embrace it as a challenge—to use it to grow and learn. If writing is your medium of expression, write! If advocating and helping others is your area of strength, do that. Share your gift with the world—we all have one. Many have gone so far as to consider their mental health challenges as a gift. I’ve known several people with schizophrenia to frame it this way, focusing on the brain’s ability to see the world around them in a way others cannot and holding onto that with pride rather than doom.

It is my hope that by keeping the conversation going and thus “normalizing” mental health issues, more and more individuals will be inspired to share their stories—the goal being the slow deterioration of any remnants of shame that may remain in the minds of those who struggle with mental health conditions, as well as in the minds of those around them.

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© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Allison Abrams, LCSW-R, therapist in New York City, New York

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Alexa

    Alexa

    June 16th, 2014 at 3:56 PM

    I am in therapy but where I would live and in the family I grew up in I would never admit this to anyone out loud. Even though I have made such huge personl strides being in therapy and don’t look to stop any time soon, this still isn’t something that I feel like I can share very openly with really anyone that I know or grew up with. I knew that I needed to make some personal changes and had some little individual demons that I needed to work out and this has been a huge stepping stone for me, but again it feels like something that I very much need to keep private. I am not sure that I feel ashamed of seeking out that help but more like other people would be ashamed of me and I don’t want to feel like I have let anyone down. Yeah, its’ another thing I am working on.

  • Joanie

    Joanie

    June 16th, 2014 at 5:16 PM

    I firmly believe that the more we talk, the more others will listen. They may not know that they or someone they love has a problem unless we are committed to getting more information about mental illness and mental health in general out into the public eye. think about the good that we can do, and the lives that could potentially be saved by just feeling more free to open up and talk about the issue. This does not need to be something that is hiddem or that feels shameful; this is a sickness just like any other, and those who struggle with this deserve the same treatment and respect that anyone else with any other illness deserves in their life.

  • Matthew H.G

    Matthew H.G

    June 16th, 2014 at 8:25 PM

    I for one agree with you wholeheartedly! The stigma surrounding mental health continues to be very relevent. Despite the great societal gains that have been made, let’s not declare victory just yet. My hope is that one day, sooner rather than later, we as a collective society will view an individual that chooses to utilize pharmacotherapy because of whatever reason, their brain doesn’t release as much dopamine resulting in them not feeling great a lot of the time, will be seen in the same or similar light as someone who for whatever reason needs to take insulin to regulate their blood glucose.

  • Brooke davis

    Brooke davis

    June 17th, 2014 at 4:11 AM

    I wish that I could be one of those who can say that I did it all on my own but I did need help with my medications to finally get everything under control. You are right, there are people who kind of look down their noses at those of us who have to take any kind of medication to help help regulate our moods, but for me I have tried to get past that shame because I know that this helps me and is making me whole again. If others don’t like it so be it, they make choices for them and I make mine.

  • Stover

    Stover

    June 17th, 2014 at 3:24 PM

    A huge hindrance that continues for many is the lack of availablility of services for them. They want to do something to make their lives better but where they live, it isn’t quite a possibility. Increasing services for folks in rural areas especially would go a long way toward making this transformation happen.

  • Reagan

    Reagan

    June 18th, 2014 at 4:19 AM

    Talk talk talk
    Don’t be ashamed of the things that you are going through
    We all have difficult times in our lives and we don’t have to feel bad about that
    Without talking about it then others will never know that they are not alone
    Once we begin to realize that our situation is not unique, this helps build a community
    And with that community comes more open and honest communication amongst one another
    And with that comes the feeling that this does not have to be hidden, that to rid ourselves of the pain that this can cause, we have to open up about this experience and know that there will then be someone who can relate to this and who may even shre their story with you

  • donny

    donny

    June 19th, 2014 at 5:46 PM

    I would love to be able to say that we treat those with mental illness the same as we do others but I know that there is still a great deal to be done until we get to that point. I think that we have actually gotten to a point where people are beginning too open up about it a little more than maybe in the past but there is still a lot of work to do before there is complete and total acceptance.

  • Jessica K.

    Jessica K.

    June 21st, 2014 at 8:44 AM

    I am not sure when it become the thought that seeking out help for something makes you weak. We all go to the doctor or at least consider some medication if we are physically ill, then why don’t we have the same thoughts about someone being mentally ill? What are they supposed to do, suffer in silence because it makes others feel sort of uncomfortable to talk about it? Look, none of us are perfect, there is not one of us who can’t use some help from time to time. The people who I think are the bravest are those who own up to the fact that they do need help, but they could use some support and who go out and find that. That to me is the bravery that is never recognized and prized.

  • Eva

    Eva

    October 8th, 2014 at 7:00 PM

    You are a wonderful writer!
    You express things so lovingly and have a strong grasp of the reality of situations.
    I can fully relate to you when you say:
    Often, out of pain, one is forced to grow and to change. Remaining static is not an option. One who has fought his or her way out of the debilitating abyss of depression or the paralysis of anxiety, or any other affliction of the mind, and came out on the other side can truly understand the meaning and the joy of being free from its grip.

  • Kate R.

    Kate R.

    October 21st, 2014 at 12:32 PM

    From my experience with a daughter and daughter-in-law, the most shaming and difficult part of taking meds for mental health is a deeply embedded cultural fear of “druggies.” We have been humiliated by pharmacists who loudly question our need for the medication; many meds are so tightly controlled that my daughter and d-i-l are often caught a day or 2 short on essential meds (try a week without a mood stabilizer–physically and psychologically very difficult) because they can’t get the needed scrip from overly-busy (or clueless) therapists and MDs. Many very competent therapists are not able to prescribe medication, and connecting to those professionals who can (and will) can be so time-consuming, humiliating, and frustrating that it’s very tempting to just give up. I know my daughter could not have reached the level of precarious progress she has gained without me fighting many battles (including being yelled at and threatened) just to get access to completely acceptable (therapeutically, not societally) medications. I haven’t seen this attitude change very much in the past 20 years, although many therapists are now much more helpful and open to the need for meds in order to benefit from other therapies. Getting, and paying, for such meds is a whole other ball-game (or war, actually).

  • Carrie S.

    Carrie S.

    December 16th, 2014 at 8:08 PM

    I cannot, nor could I ever, hide my mental illness. It started when I was 14 years old with cutting. That was totally unheard of in 1987. Everyone in my school knew. Everyone in my town knows. I have deep scars everywhere on my body. Strangers I come into contact with know. So, years ago, I just owned it. I tell people anything they want to know about having bipolar disorder. I explain what psychosis really is, as apposed to what Hollywood says. The way to combat stigma is to tell those who don’t know what it’s like about the truth behind our diagnosis.

  • Brad D.

    Brad D.

    March 3rd, 2015 at 11:41 AM

    That sounds like the path of healing to me dear…. And one of humility and truth…. Sweetheart, that is where God dwells, and the enemy cannot hide in the light of truth.

    “Confess your sins (weaknesses) with one another and be healed”. Body mind and soul.

  • Harper West, MA, LLP, Psychotherapist

    Harper West, MA, LLP, Psychotherapist

    June 1st, 2016 at 6:29 AM

    While I agree that we need to fight against the stigma of having a “mental illness” I must challenge your support of the falsehood and myth that “mental illness” is caused by imbalances in neurotransmitters. Please check your facts and the current research before you make false statements.

    Quoting from my book “Self-Acceptance Psychology”:
    “The DSM and the biomedical or disease model are based on deeply flawed assumptions — specifically that “mental disorders” are caused by imbalances in brain chemistry or are passed along genetically. Quite simply, but very significantly, for conditions such as anxiety, depression, ADHD, and personality disorders, these concepts have never been proven by research.”
    Sadly, the ostensible disease model and the DSM are promoted by psychiatry and the pharmaceutical companies, two industries that make billions of dollars selling and prescribing psychoactive drugs despite well-documented harmful side effects and lack of efficacy. Big Pharma, colluding with their paid researchers in academia, has spent millions or perhaps billions of dollars convincing physicians and the America public that popping a pill will “fix” the neurotransmitters in one’s brain and “treat” depression, anxiety, ADHD, or schizophrenia.
    This theory has never been proven to be true. Neurotransmitters cannot even be measured in the brain to determine if there is some presumed shortfall or excess. Peter Breggin, MD, a longtime advocate for appropriate prescribing of psychiatric medicine, writes that the idea of biochemical imbalances is sheer speculation aimed at promoting psychiatric drugs. (Breggin, P.R. (2001) The Anti-Depressant Fact Book. Cambridge, MA: Da Capo Press, p. 21)
    In fact, psychoactive drugs often make mental health and functioning worse, as Breggin notes in many of his books. There is more and more evidence that all classes of psychiatric drugs produce chronic brain impairment and diminished enjoyment of life. Worse yet, these drugs frequently prevent recovery and can cause chronic or permanent disability. ( Breggin, P.R. (2014) Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions. Amherst, NY: Prometheus Books, p. 262)
    Millions of dollars in research funding have been thrown at trying to prove a biological cause of emotional problems, with an almost frantic avoidance by psychiatrists and pharmaceutical companies to even consider other explanations. This smokescreen of the disease model has distracted the profession and researchers from some obvious truths that actually do explain emotional wellbeing in a fact-based, common-sense, research-proven manner.”
    As I go on to explain in my book, there is no such thing as “mental illness,” for most conditions we label as anxiety, depression, ADHD, PTSD, etc etc. The effectiveness of most psychoactive medications is due largely to the placebo effect — believing desperately that it will work.
    Self-acceptance Psychology sprang out of wanting to share my own experience with the wonderful, liberating power of becoming self-accepting, and of my frustration as a psychologist with the way normal human reactions were stigmatized and labeled as “mental disorders.” Self-acceptance Psychology states that normal human reactions — such as fear, shame, self-criticism and the need for love and belonging — should not be labeled as “mental disorders” and stigmatized and medicated. They are just fear — often based on low self-worth and shame. The solution to self-doubt is finding compassionate self-acceptance, so that internal judgments and the high need for approval decrease. NOT with medications that numb the emotions, tranquilize the body and brain, or over-stimulate with amphetamines.

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