Untangling Stigma From Support in Mental Health

I used to think, with genuine honesty, that people with mental health disorders were their own worst enemy. “If only we would stop stigmatizing ourselves,” I would say, “others would stop stigmatizing us! We set the example! We tell people how to treat us, what to believe about us.”

Bullshit. The stigma of this nation is as thick inside us as the blood in our veins. I conveniently ignored the blatant reality that to a stranger I could always just be “that bipolar girl,” thinking people everywhere would start to change if the mentally ill communities across our country would start to speak up and out and begin changing them. 

I believed this to be true because I thought myself so seldom affected by the discrimination and prejudice of social stigma in my day-to-day life, but I realize now – now that I have a young daughter on the cusp of being assessed and joining our little labeled club, now that I am hypervigilant and hyperaware – that I just didn’t realize before what is suddenly an obvious truth. Stigma is everywhere. All around me. The stench of it permeates my every day.

I am loud and proud in my diagnosis and have been for some time. I am often in the face of people, waving around my “mentally ill” identity card, so that those who still hide in shadows may feel emboldened to at least show their toes.

And in return, yes, my rather small community of acquaintances and friends (most of whom only see me at my best) know me for who I am. My eccentricities are accepted and my boundaries are, for the most part, respected. However, in far too many instances and in far too many relationships, I have been confusing what could be better described as affectionate tolerance for support.

The fact is you cannot support a person with a mental illness and also stigmatize mental illness itself.

You cannot say with one breath, “I am so glad that medicine works for you,” if you must use your very next breath to remind me, “I mean, I would never take them personally, but I’m glad they help you.”

And if you read that and laugh or are filled with an enraged sense of ‘but who would possibly?’ Don’t be. You would. In a thousand different ways all around me. You just don’t realize it yet. But I’m going to tell you. I’m going to keep on posting about this until I am heard and understood.

If you have ever chatted at length about how much you hate pharmaceuticals and Western medication but laughed about the “fun ones”, if you have asked a person if they plan to wean off their medicine and try something different at some point, if you initiate conversations suggesting herbs instead of pharmaceuticals to people currently on or planning to be on those pharmaceuticals, you are stigmatizing mental illness. It’s in there.

If you have been battling depression or anxiety for months or years, refusing medical care of all kinds, all the while telling me that my illness doesn’t bother you, I see you. If you can’t face your own mental illness, I don’t care what you say to me, I know how you feel about mentally ill people.

If you think the right question to ask is, “how can we best make these normal activities more palatable for you?” then you might not be offering the kind of support you think you are and, again, you may be existing in a relationship tainted by the societal stigma none of us can seem to escape.

Has it occurred to you that by offering to help your friend better normalize (possibly in an environment that leaves them feeling anxious, depressed, overwhelmed, or uncomfortable) you may be contributing to their sense of stigmatization? You are telling them that their normal isn’t as good as another normal – the “real normal,” but that you’re here to help them change so they can be more like the rest.

What people want, sick and healthy alike, is someone to keep them company while they relax into being themselves.

The real truth is most people have no idea how to best support a person with a mental health diagnosis and most seem to have little interest in learning how.

In large part, I understand. It can be a hard ask. Sometimes it can be a sacrificial reaching out. Other times it can be working to understand a new boundary. It can mean finding a quieter hang out in order to see a particular friend, or always visiting another one at their house. It can be awkward. It can feel a little embarrassing while everyone tries to figure things out.

As a quick insider tip, if you do happen to be interested in knowing how to support a person with a mental illness, a great place to start is asking that person the most effective way to support them specifically. Then, actually do what they tell you not some other thing that you think is probably what they meant to say.

People are individuals, even the ones crammed into a tiny little box labeled “mentally ill”. Good support, just like good relationships, absolutely cannot happen without communication.

We can’t always help our societal stigmas. Our biases were ingrained into us as children before we even knew what was going on. But we can choose to listen and see them. And when we do, we can make the choice to change.

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