Spend time on social media reading posts on mental illness and mental health and you’ll soon come across many of mental health’s other “S” words: stigma and shame, silence, survival, sharing and support.
Post after post will decry social stigma, railing against the injustices it creates in the availability of services, both in terms of financing and accessibility. In my mind, there’s no doubt that for many years, government spending on mental illness has paled in comparison to that of physical ailments. This despite the fact of the prevalence of mental illness and the cost it brings to the economy. Studies indicate that one in five people suffer from some form of mental illness, and that time taken from work due to mental illness costs billions in lost productivity. In addition, the best treatments are often not funded by universal healthcare and private treatment is beyond the ability of many.
Less frequently mentioned is shame but I know, from my own personal experience, that it plays as large a role in creating silence as does social stigma. Many, myself included, find it shameful to be unable to end their suffering, especially when there seems to be no apparent reason for it or there are others who seem to be worse off.
But what exactly are stigma and shame?
The Centre for Addiction and Mental Health (CAMH) tells us that stigma “refers to negative attitudes (prejudice) and negative behaviour (discrimination) toward people with substance use and mental health problems.” It goes on to describe some stigmatizing behaviours:
- having fixed ideas and judgments—such as thinking that people with substance use and mental health problems are not normal or not like us; that they caused their own problems; or that they can simply get over their problems if they want to;
- fearing and avoiding what we don’t understand—such as excluding people with substance use and mental health problems from regular parts of life (for example, from having a job or a safe place to live).
We’ve all, in one form or another, faced such behaviours, the casual references to just “get over it”. I know I’ve been told, more than once, that my illness was my own fault. My answer is typically one word, “How?” but I never have received an answer.
Shame is somewhat different. According to Wikipedia, shame is a painful emotion caused by comparing your own actions to your own standards. In other words, you see yourself as failing to live up to an inner expectation; it flows from a disquiet within oneself. The standard or expectation may be based on perceived social norms, perceived being the keyword. The norms may not exist or they may be less restrictive than your own expectations.
Webster’s dictionary puts it this way:
The shame I experienced was a combination of guilt and perceived shortcoming; guilt at my inability to “fix” myself, guilt at having nothing “wrong” with me yet feeling so bad; shortcomings in my roles as a dad, provider and more. In fact, I perceived myself to be lacking in everything. It didn’t matter that it wasn’t true. I didn’t see that. It was all about perception and my perception was that I was less than.
Together, the stigma imposed from without, and the shame imposed from within, worked to silence me. I bore my suffering without complaint, being diminished as time passed until I could bear no more. I acted in the most extreme way possible. To my good fortune, I survived and was introduced to two other of mental health’s “S” words, sharing and support.
In my case, sharing is all about telling my story. I tell it to whoever will listen, and often to some who will not. This isn’t natural to me. I’m a very private person. But it quickly dawned on me that this tendency to privacy had worked to my detriment. It fed into the silence. The antidote, then, is to speak out.
My illness, Major Depressive Disorder, abhors sharing. It works very hard to create its ideal state, isolation. For someone like me, someone who prefers his own company, who prefers privacy, this tendency to isolation grows imperceptibly, in small increments, until it overwhelms. It feeds on the guilt and perceived inadequacies, undermining your self-esteem, eroding it until it’s no more.
But sharing works against this. By sharing, you challenge the isolation… You tell it that you’re no longer going to bear the suffering alone. You tell yourself that you aren’t lacking. You tell yourself that you’re ill and that the illness doesn’t define you. You tell yourself, and see convincing evidence of the fact, that you aren’t alone. Sharing, in other words, is something that must come from within. As such, it’s the antithesis of shame.
By speaking out, I gained the confidence needed to set aside my shame and thereby open the door to support. I was directed to resources that could help me, resources like the CMHA, Durham Family Services, COPE and more. Through my writing, my sharing, I also received support from the online mental health community. From the CMHA I gained a roadmap to and through the mental health system. Durham Family Services and COPE gave me individual and group counselling. Supports taught me mindfulness. Supports taught me distress tolerance. Most of all, supports taught me that my illness can be managed.
Notice that support, like stigma, comes from without. Support, therefore, is the antithesis of stigma.
I think that’s important to keep in mind. How these words, mental health’s other “S” words, can, on an individual basis, provide a solution to overcome social stigma and personal shame. Social support is there. Sharing can be utilized. Yes, more needs to be done, after all social stigma remains widespread, ingrained in the very language of society, but support and sharing offer a respite, a solution, for the individual as we work to end stigma and reduce shame.
Thank you for reading.
About John Dickson
A lifelong battle with Major Depressive Disorder resulted in a suicide attempt. That attempt taught me the danger of being silent about my personal struggles with mental health. I've had to learn to be more open about my struggle. I now choose to reach out with the hope that someone will be inspired and end his/her own silence. I'm a dad, a blogger and a new convert to the power of social media.