When clinical psychologist Deborah Serani, PsyD, was diagnosed with depression, she was relieved. But soon after the comfort and relief dissipated, she felt shame and guilt and even started reconsidering her profession.
Serani writes poignantly about this so-called self-stigma in her beautiful, information-packed book, Living with Depression:
…I felt inadequate and embarrassed by my diagnosis. I knew that society feared anything that strayed from the norm, and the idea of being seen as different, disabled, or dysfunctional really frightened me. I didn’t tell anyone about my depression, kept my medication hidden in a bedside dresser, and kept secret my feelings of failure. I even went so far as to believe that I should hang up my shingle as a practicing psychologist because, clearly, I was incapable of taking care of myself as a person. How could I take care of others as a professional? Despite the fact that I was a psychologist educated in the mind, brain and body, the misconceptions about mental illness shoehorned themselves into my life.
Fortunately, as Serani started feeling better, these negative thoughts and feelings went away.
In her book Serani outlines other types of stigma, and provides tips for dealing with them.
Types of Stigma
- Public stigma: Oddly enough, it seems like public stigma is actually swelling. Serani cites research that found that 70 percent of people didn’t want someone with a mental illness marrying into their family, 60 percent didn’t want to work with someone with a mental illness and 40 percent didn’t want to be friends with someone with a mental illness. Mass media, writes Serani, plays a powerful role in perpetuating public stigma, portraying mental illness in a negative, belittling and dangerous light.
- Professional stigma: Surprisingly, stigma can live in the health care and even mental health fields. Serani writes, “In my personal experiences, health care workers who had little understanding of mental illness would make jokes about my prescription, speak condescendingly to me, and one even requested not to be left alone in the room with me during a procedure.”
- Label stigma: While diagnoses are important for identifying illness and determining the best treatment, they also can create an “us” vs. “them” distinction: Either a person is violent or crazy or they’re calm or cooperative. Label stigma can lead people with mental illness to “label avoidance,” according to researcher Patrick Corrigan, PsyD, and colleagues. Basically, people hide their diagnosis, avoid places that offer services or deny themselves care, Serani writes. She’s seen this at her own practice. Some clients choose to pay Serani out of pocket without getting reimbursed by their insurance company for fear that their diagnosis would follow them.Serani also experienced label avoidance. For a year, she’d peel off the label from her Prozac and went to a pharmacy several towns away for her psychiatric medication but kept her medical prescriptions at the pharmacy around the corner.
- Stigma by association: Just being the family member, friend or even neighbor of someone with a mental illness can get others to look down on you as well. Serani shares what happened when she opened a practice out of her first home: The neighbors were appalled and worried that “sick degenerates” would be roaming the neighborhood, putting kids in danger. After some time and proof that the people seeking Serani’s services were just like them, her neighbors’ concerns went away – and, as she writes, “nearly everyone in the neighborhood sought my advice, counsel or friendship at one time or another.”
Disclosure is a Personal Choice
How much you reveal about your diagnosis and to whom is up to you. Serani describes two types of disclosure in her book: “indiscriminate disclosure,” where you share your diagnosis with everyone; and “selective disclosure,” where you share your diagnosis but only with certain people at certain times and in certain places.
6 Tips to Deal with Stigma
Serani lists these six tips for dealing with stigma.
- Educate yourself on the above types of stigma and consider your own beliefs about mental illness.
- If you can’t disclose your diagnosis, that’s OK. Give yourself permission to keep it hidden.
- If you’re thinking about revealing your diagnosis, remember that it may be easier to start with “selective disclosure.”
- Join friendly and reputable organizations that advocate for people with mental illness. Serani lists BringChange2Mind, the StigmaBusters of the National Alliance on Mental Illness, or Sane.
- Help kids and teens understand the upsides and downsides of disclosing their diagnosis. According to Serani, because they tend to be more open about personal information, they’re also more vulnerable to being stigmatized.
- If stigma feels particularly intrusive, see a therapist for individual or group counseling.
What’s helped you in dealing with stigma? Please share below. It’d be great to learn about additional effective strategies.