How to Cope With Stigma When You Have a Mental Illness
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Medically reviewed by Steven Gans, MD
Stigma involves negative attitudes or discrimination against someone based on a distinguishing characteristic such as a mental illness, health condition, or disability. Social stigmas can also be related to other characteristics including gender, sexuality, race, religion, and culture.
Unfortunately, stigma surrounding mental health is still common. While stigma is not limited to mental conditions, attitudes towards psychiatric illnesses tend to be more negative than that toward medical conditions.
Research has shown that stigma is one of the leading risk factors contributing to poor mental health outcomes. Stigma leads to delays in treatment. It also reduces the chances that a person with mental illness will receive appropriate and adequate care.
History of Mental Illness Stigma
Mental illness has a long history of being stigmatized in societies around the globe. From being thought of as the mark of the devil to being considered a moral punishment, the ideologies around the etiology of mental illness have ranged wide.
As a result, treatment has historically not always made scientific sense and has been brutal and inhumane. Dating back to Neolithic times, trephining, for example, involved chipping a hole in the person's skull to release the evil spirits. Treatment of mental illness has come a long way since then, but the fields of psychology and psychiatry are relatively young and still have a long way to go.
Stigma has arisen out of fear and a lack of understanding. It has persisted even with greater knowledge about the biochemical and genetic natures of different conditions. The representation of mental illness in mass media can add to the stigma.
As scientists continue to learn more about the causes of mental illness and develop effective treatments, it is hoped that stigma will decline.
If you or a loved one are struggling with a mental condition, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Related:How Mass Media Reinforces Mental Health Stigma
Signs of Stigma
Examples of how stigma is perpetuated include:
Media depictions where the villain is often a character with a mental illness
Harmful stereotypes of people with mental illness
Treating mental health issues as if they are something people can overcome if they just "try harder" or "snap out of it"
Using phrases like "she's crazy" or "he's nuts" to describe other people or their behavior
Halloween costumes that depict people with mental illness as violent and dangerous
Anyone who has had experience with mental illness, personally or professionally, can tell you that despite advances in psychiatry and psychology, a great deal of stigma remains. While people have become more informed about mental disorders in general, stigma continues to be a reality.
Related:How Halloween Costumes Contribute to Stigma
Types of Stigma
The stigma associated with mental illness can be divided into two types:
Social stigma, which involves the prejudiced attitudes others have around mental illness
Self-perceived stigma, which involves an internalized stigma the person with the mental illness suffers from
A 2013 review of studies on the public stigma of mental illness showed that stigma is still widespread, even as the public has become more aware of the nature of different mental health conditions. While the public may accept the medical or genetic nature of psychiatric illness and the need for treatment, many people still have a negative view of those with mental health conditions.
Prevalence estimates suggest that stigma is common, although it varies depending on the population, condition, and individual factors. For example, the prevalence of perceived stigma among people with schizophrenia is around 62.6%. Self-stigma, which involves internalized negative attitudes, is also common, affecting around 54.4% of people with psychiatric conditions.
Perceived stigma leads to an internalized shame about having a mental illness. It has been found in a long-term study that this sort of internalized stigma leads to poorer treatment outcomes.
Causes of Stigma
Mental health stigma has been attributed to a number of different factors. Some causes that potentially play a role include:
Stereotypes
Generalized and discriminatory stereotypes about people with mental illnesses often play a major role in stigma. For example, people with mental illness are often stereotyped as violent or unpredictable. While this stereotype is common, the reality is that people with mental illness are much more likely to be the victims of violence than to perpetrate it.
Lack of Awareness
Many people simply lack awareness of symptoms, causes, prevalence, and treatments for mental illness. This lack of understanding contributes to poor perceptions about different mental illnesses and the people who experience these conditions.
According to the National Institute of Mental Health, one in five American adults, or around 52.9 million people, live with a mental illness.
Media Portrayals
Media depictions of people with mental illness also play a part in perpetuating stigma. Mental health conditions are often depicted negatively, and media reports often attempt to link criminal activity and violence to mental health problems.
Impact of Stigma
The consequences of stigma can be serious and devastating. With stigma comes a lack of understanding from others, which can be invalidating and painful, but stigma also carries more serious consequences including fueling fear, anger, and intolerance directed at other people. People who are subjected to stigma are more likely to experience:
Reluctance to seek out treatment
Delayed treatment, which increases morbidity and mortality
Social rejection, avoidance, and isolation
Worse psychological well-being
Poor understanding among friends and family
Harassment, violence, or bullying
Poor quality of life, disability, and increased socioeconomic burden
Increased feelings of shame and self-doubt
The stigma surrounding mental health can make it less likely that people will seek treatment. Some conditions may worsen over time without treatment, so failing to seek treatment ultimately worsens outcomes.
Stigma can also cause people to doubt themselves and their abilities to achieve their goals in life. It can also lead to feelings of shame and even isolation. It may make it harder for people to find jobs and adequate housing.
Tips to Combat Stigma
Overcoming stigma is not easy, but there are steps that you can take to deal with negative attitudes about mental health conditions. There are some things that you can do to help combat both social stigma and self-perceived stigma about mental illness.
Remember that many people experience mental illness: If you have a mental illness, know that you are not alone. One in four Americans has a mental illness of some kind.
Find mental health resources: Whatever you do, stay connected to others and get support. Organizations such as the National Alliance on Mental Illness (NAMI) offer educational and supportive resources for people and families affected by mental illness.
Join a support group: Consider joining a support group where you can talk to others who have had similar experiences. These groups can be a great place to find support, comradery, encouragement, and tips.
Get treatment: While stigma can make it less likely that people will seek treatment, getting the help you need can help with symptoms and contribute to a better quality of life. Psychotherapy can help people learn to identify and change the negative thoughts that play a role in stigma.
Seek social support: Isolation can make mental illness and stigma more difficult to cope with. Unfortunately, it is not uncommon for people experiencing mental health problems to avoid spending time with others.
Speak out: Educate people around you about the realities of mental illness, including how common it is, and actively speak out against stigma. Debunk myths about mental illness, such as the idea that people with schizophrenia are usually violent. If a family member or friend makes a disparaging remark about someone with a mental illness, educate them and have a no-tolerance policy.
While stigma continues to exist, it can be eventually eliminated with greater education and awareness about mental illness.
