what i've learned about mental illness stigma and secrecy
10 things i've learned about mental illness stigma, secrecy, and shame
In my experience, you can't fully appreciate how pervasive and damaging our society’s mental illness stigma is -- until you're diagnosed yourself. When an entire society has irrational and harmful views, it's hard to actually see it — it’s easy to dismiss its existence and effect. One reason is that you don't have to face the stigma personally. It remains distant and abstract. Before my bipolar diagnosis, I had heard of the word “stigma”, but I didn’t give it much thought. Then I was diagnosed. Suddenly, the impact of stigma was real, and it was withering.
Experiencing society's irrational fears and prejudices about a medical diagnosis — now my medical diagnosis — truly opened my eyes to the needless pain and suffering caused by irrational prejudice in all its forms — I can better appreciate now the true pervasiveness and damage of the other irrational fears, biases, and stereotypes that still exist in our society.
In my experience, the spoken and unspoken assumptions and generalizations that exist --- collectively, society's irrational stigma about mental illnesses and anyone else who is “different” — all of it causes us — those who have it, and who might have it — to conclude the safest action is to hide in fear and secrecy. It’s a completely rational course of action in the face of the deep stigma that exists. And it helps neither the person nor society. Imagine a culture that drives you into secrecy if you have diabetes. Or cancer. That’s what happens in this country, as to mental illness, every day. Among other things, it keeps people from seeking help.
In my experience, the causal chain of society's stigma is dangerous and stark: Stigma causes real fear. Which causes secrecy and shame. Which keeps people with a medical illness from seeking and receiving treatment. In many ways, it is similar to anosognosia, which many people with severe mental illness also suffer, which causes an inability to perceive or realize that you’re sick, which keeps you from seeking treatment. Both stigma and anosognosia need to be addressed. To continue to allow this overall chain of events for so many people is immoral, and, ultimately a violation of several basic human rights. It causes needless suffering, and it can be lethal. It almost was for me.
In my experience, stigma irrationally damages not just the ability to get treatment, but even the ability to get the basic human needs of housing and employment. Have no doubt, it really does. When I was getting back on my feet, in initial recovery, I was bluntly advised, by people across many professions, to absolutely hide my diagnosis, at all costs, when trying to rent a place and get a job. This can be terrifying, especially if you have a diagnosis, like bipolar, that includes depression. Because once you have no options for even the basics like a place for sleep and a job for food, I learned how easy it is to fall into a dark depression, including thoughts of suicide. This is what stigma can lead to: A very real lack of options for even the most basic things.
Over the course of my six years of dual diagnosis recovery, including my coming out publicly that I have bipolar 1, I’ve talked about this with all kinds of people about this, and it seems clear: For at least a half-dozen reasons, mental illness stigma is as fundamentally irrational as racism, misogyny, homophobia, or any other kind of baseless bias or stereotype. Which makes me wonder how best to try and put an end to it, given what we’ve seen as to these other kinds of irrational prejudices.
In trying to unpack mental illness stigma, in order to end it, I've also learned that, for some illogical reason, many in society think it's somehow valid to draw conclusions about an entire group -- here, all those with a diagnosed mental illness -- based on what they may have heard about one single person, somewhere — who may not even have a diagnosis. The example here is hearing about someone in the news, and assuming they have a diagnosed mental illness, and assuming further that everyone with the same diagnosis must be the same kind of person. This type of thinking has serious logical and evidentiary flaws. Yet it is how much of our society thinks. The fact that this thinking is part of society's norms just further shows how pervasive the mental health stigma really is.
Similarly, I've also learned that, for some illogical reason, many in our culture think that anyone acting in a bad way is likely to be mentally ill -- and that, in turn, all people with a mental illness have a propensity to be bad. To think that an entire group of people is bad, just because one individual has committed an act — an individual who may or may not have an actual diagnosis — Here again, this type of thinking, for the same reasons, has serious logical and evidentiary flaws. As a lawyer, I know how absurd and indefensible such thinking is. No impartial judge would allow it. Yet we allow it, and indulge in it, in our society. It further shows just how pervasive mental illness stigma is.
In my experience, no amount of social or professional standing can make you immune to stigma. When the onset of my bipolar 1 occurred, in my late 20s, I was a successful lawyer at one of the leading law firms in the world. I had strong community, social, and professional standing. You'd think that I could brush off stigma, and not let it affect me, given the advantages I had. But stigma is so pervasive, and so damaging to the person with the diagnosis, that it became rational for me to conclude -- in fact, it became the objectively smartest option at the time -- to go deep into secrecy, in order to preserve my career -- to be able to have any employment in my chosen profession. The stigma of mental illness is real.
Since we as a society have not yet ended other types of prejudices — racism, sexism, homophobia, and other "-isms", I unfortunately doubt we'll end mental illness stigma anytime soon, either. Note that our society and culture has not even been willing to give mental illness stigma its own “ism” for a name yet. Talking about mental illness is essential, but it isn't enough; stigma will still exist, and it will still harm those who most need access to help. So I advocate for full access to psychiatrists, and full access to talk therapy, and prescription medicine, and I advocate for the full inclusion for those of us who have these medical diagnoses. I advocate for inclusion because it helps, and because it is right. Full inclusion will peaceably, yet firmly, show the true irrationality of mental illness stigma — and the actual value that we can add to society with our uniquely-built minds. This is a human rights issue, as well as an opportunity of human possibility -- just one of many being ignored in our present times.