Recently someone asked me how to deal with mental health related stigma. Stigma shows up in all sorts of ways, and the way in which we respond can affect us, the person or people who have demonstrated the stigma, and those witnessing the stigmatizing event. Some people choose to keep their mental illness a secret, some choose to shout it from the rooftops (or write a blog about it 😉 ), and some share their diagnosis with a select few trusted individuals. Often, people choose to share freely with some groups and not with others. Everyone has the right to make this decision for themself, and as such, responses to stigma may vary.
Stigma in the Workplace
If you feel that a superiors knowledge of your illness is keeping you from getting a promotion, a sought after raise, or has even contributed to you losing your job then that is an infringement on your rights under the ADA (Americans with Disabilities Act)*, and it would be a good idea to consult an attorney. If coworkers know about your diagnosis and treat you differently or poorly it might be worth trying to talk with them, telling a supervisor, or going HR. Employee handbooks will cover workplace bullying and/or harassment; which this may or may not fall under depending on the circumstances.
If you have not shared with anyone at work that you have a mental illness and you experience stigma such as hearing an unkind joke about a mental illness, or an uneducated opinion about people with mental illness than you can do one of three things. You can remain silent and go about your day, you can say something in the defense of people with mental illness without giving away personal information, or you can share your story and use it as an opportunity to teach people.
Stigma with Friends
Knowing who to share your struggles with can be hard. Often friends can be a savior during a rough patch, but other times their actions can make things worse. Experiencing stigma from a friend can be painful. If educating your friend does not seem to be a viable option, than making a decision based on your friendship and your own well being is both difficult and necessary. Sometimes fighting to keep the friendship despite stigma can do more harm than good.
I have someone who I was very good friends with while I was drinking, before my mental health took a dive. This person was obviously uncomfortable when my first hospitalization occurred, but quickly moved back to our old easy friendship (once I learned not to talk about depression with her). Once I admitted to myself and others that I was an alcoholic and moved into a life of recovery, she completely retreated from our friendship; I would text or email (we used to frequently email throughout the work day) and would rarely get a response. For a long time I thought it was my fault that the friendship ended. Since then I have started this blog and through books, therapy, and hearing other peoples stories, I have learned that it was the stigma she felt towards addiction and mental illness that killed the friendship, not me.
The reason for that story is to show that sometimes in friendships it can be hard to recognize stigma, more so than in other situations. We are typically more emotionally connected to friends than we are with coworkers or medical professionals. Because of this, identifying stigma rather than blaming ourselves can be hard. When deciding how to handle stigma within a friendship, it is important that we do what is best for us.
Stigma with Family
When a family member expresses stigma in any way towards a person with a mental illness, it can feel really personal and really painful. The stigma can make it seem like that person doesn’t love you or see you for who you are and what you are going through.
Depending on your relationship with this family member, much like with friends, your response will likely change on a case by case basis. If they are open to it, encouraging that person to go to a family support group (such as through NAMI or Al Anon) can be helpful. This allows them the opportunity to speak with others who have family members with a mental illness. Another option would be to invite them (with the consent of your counselor) to join you for a therapy session; which would allow you to talk more freely in a safe environment under the guidance of a professional.
As with friends, it is important to remember that your mental health is the most important thing, so if that means that you need to take some time away from that person, then you have every right to do so. If it means sharing in an open and honest way and then letting what happens happen, go for it. If you feel the best thing for you would be to keep your diagnosis and struggles from that person, then that’s what your should do.
Stigma with Healthcare Professionals
It can be scary when a healthcare professional treats you with stigma. You often are seeing them because you aren’t feeling well and the last thing you want is to feel put down due to your mental health diagnosis or medication list.
In the book When Doctors Don’t Listen, Drs. Leana Wen and Joshua Kosowsky detail techniques to make sure that you are being heard by your doctor. They do not cover this in the context of mental health, but the tips and tricks can be applied across the board. When you are with a doctor, be honest and assertive. It’s important to remember you are not there to make friends, but to feel better. After the visit, you can look for a different doctor for the next time you are unwell.
As a side note, I have an ongoing project collecting stories of times people have been treated poorly by their doctor because of their mental health diagnosis; while I wish this did not occur, it absolutely does. If you have an instance that this happened to you, please share it with me.
While society has come a long way since the days of chaining patients to walls and overcrowded asylums, stigma does still exist. Dealing with it can feel arduous and repetitive; but it’s important to remember that everyone can choose to deal with stigma in a way that makes them feel okay.
If you have a story of dealing with stigma, or have an additional idea of how to deal with stigma, please let me know in the comments.

*For those in the United States