Don't Speak - Self-Stigma and Mental Health

I’ve been asked twice to talk about my personal experience dealing with depression, anxiety and the use of genetic testing for mental health treatment. I became aware of this new test during a medication management appointment.

My practitioner, a psychiatric advanced practice nurse, is an expert with psychopharmacology, and very knowledgeable about the latest treatments for depression.  After trial and error with many medications, we discussed pinpointing the best antidepressant for me, through genetic testing.  

My interviews were featured on “Innovations”, a TV series on the Discovery Channel (watch here), and most recently, on a KYW-TV medical segment (watch here) during a six o’clock evening news broadcast. 

Both times, I went through a lengthy internal debate about doing the interviews. There was serious trepidation about speaking publically concerning mental health. I’ve written several articles about depression, but it’s not the same as facing a live audience to talk about it. Aimed at being an advocate for issues surrounding mental health, I accepted the invitation.

I want to dispel the existing stigma applied to mental health. Through communication and using my voice I can raise awareness. While I can research how people’s attitudes and beliefs perpetuate the stigma, and write about them – speaking publically makes a greater impact.

Social media has become a channel to learn and process information.  As a writer, I know the written word has tremendous power, but I can’t always hide behind my laptop.

I’ve worried about my perception by those who saw the interviews. Am I educating others, or exposing myself to ridicule? I realize that the stigma I want to fight resides deeply in the social psyche. In my goal to eliminate this public negativity, I have to confront that stigma is also internal.

I realize being constantly exposed to existing stereotypes reinforces my belief in them. Negatively, I apply those aspects to myself. I am a victim of self-stigma, which creates low self-esteem.

The challenge comes in dealing with the issue head on. I need to be aware of the destructive messages I deliver to myself continuously. These messages stop me from sharing about depression and how anxiety impacts my daily life. They stop me from being authentic and honest.

I give into all the unfavorable thoughts until I’m sure no one will understand. They’ll see me as weak or wanting sympathy. I tell myself, “Don’t talk about a mental health condition. People will feel uncomfortable, unsure of what to say and will ultimately turn away.”

Thus, the thoughts become a conundrum. How can I move forward on my public campaign unless I can remove my self-stigma? I must be bold with my conversation, speak honestly and take a jump into the unknown.

If I was diabetic, I wouldn’t be concerned about telling people about a blood sugar attack, so why is there hesitancy about discussing a panic attack? They are both symptoms of a medical condition and are caused by chemical reactions within the body. The safety zone seems to end at the neck.

Any conditions that stem from chemical brain imbalances remain a gray area in the gray matter. Right away the stigma seeps in and many people go right to “he’s crazy,” “there’s something not quite right with him,” “he needs to take a chill pill,” or “boy, he likes drama.”

People are quick to perpetuate a stereotype rather than look beyond it. It’s easy to understand a brain tumor, because there is a physical manifestation. Giving the same legitimacy to an unseen condition inside the brain is more difficult. Biochemical conditions that effect personality and behavior can be too complex for some to deal with.

It creates fear, and what do we do when we are afraid of something? We stay away from it. People may fear individuals who are identified as bi-polar or schizophrenic. Different behaviors make us uneasy. There’s no risk in avoiding what seems out of the norm.

Everyone can be more empathetic. If you are self-stigmatizing, then the empathy needs to be directed inward.  I’m learning not to discount my health, and to stop pretending that everything is always status quo.

It is important people understand there are many facets of depression. Many individuals have what is known as “high-functioning depression.” While everything can look fine on the outside, there can be turmoil, despair and loneliness raging inside. Without being able to share about the symptoms and struggles in an honest conversation – assumption, misunderstanding and stigma continues.

I know I can only help others with mental illness if I can be honest about mine. Too many times I’ve avoided the subject or just said “I’m fine” when someone asked how I was. 

Very few people know I have the national suicide hotline number programmed in my phone, or that I have a safety plan in case I want to harm myself. I’ve never shared about the time I sat in my car with the engine running, the garage doors closed and windows open, wanting to shut off my brain.

I haven’t talked about days when it’s hard to get out of bed, to get dressed, concentrate on writing, leave the house or feel happy. It all remains inside, but these are effects of the disease.

As with any personal topic, there is a concern about how much we disclose and what seems appropriate. Is it okay over lunch or dinner to let a friend know you’re struggling with your depression?

The disease can be hard to verbalize at times. It becomes more difficult when you’re not sure how friends and family will receive the information. It’s not without risk, but I must be willing to accept it if I want to make the conversation easier for everyone.

Being able to talk openly about mental illness is vital. I see a therapist on a weekly basis, but that shouldn’t be the only time I can share about my struggles. I’m learning to utilize Cognitive Behavioral Therapy (CBT) to deal with the negative self-talk.

There are positive aspects to CBT that everyone can benefit from, but I don’t share those. Keeping it withheld like a dark secret is because I’ve bought into the stigma.

Mental illness doesn’t define me. It is just a medical condition I must deal with. It’s not about making excuses for my behavior; it’s about educating others to the symptoms.

Talking let’s people know what might be assumed in silence. Individuals can feel I’m aloof, disinterested, distant, self-absorbed, antisocial or just shy. At my core, I’m none of those things, but I’ve worn those labels. That’s what happens when I don’t speak up.

I don’t want to be an assumption, a whispered opinion or a misunderstanding. It’s time to shed the self-stigma. Those diagnosed with a mental illness should be able to talk about it and everyone should listen.

According to the National Alliance on Mental Illness – approximately 1 in 5 adults in the U.S.—43.8 million, or 18.5%—experiences mental illness in a given year. Out of that population 16 million are diagnosed with depression.

There are so many stories out there waiting to be heard. I want to know that every time I share about my mental health issues, I am making it easier for someone else to speak out. The conversation has to grow and the stigma has got to end.