Stigma begins during mental crisis and hospitalization, but its effects are far reaching. Stigma continues years afterwards. It affects the sufferers in nearly every aspect of their lives.
Until it had a name, I didn’t know what was the horrible feeling that plagued me throughout my twenties. It’s called “Stigma”. Stigma is shame imposed from without but accepted from within. I won’t be citing outside sources or adding scholarly footnotes to this essay because it is written from a place of deep knowledge. Anyone who has been hospitalized for a mental illness and spent time recovering knows what I’m talking about. No psychologist or doctor can describe it from this angle unless they themselves have been hospitalized.
The first thing that happens is that you learn what it means to be dismissed. In an acute crisis, you may be saying things that feel very true to you, but don’t sound plausible or true to a nurse or doctor on the ward. They have learned to shut off when you start speaking and respond with pat phrases like, “I’m sure you feel that way.” or “That must be really scary for you.”
It’s not really the medical staff’s fault; it’s exhausting to follow the logic of someone in mental crisis. They are protecting themselves. But when you come out of that psychotic or depressed state, the dismissal continues.
For instance, you might say, “I have an unbearable, sharp pain in my left side.”
They respond, “How awful for you.” But they’re not going to do anything about it unless they see outward signs. You’re imagining the pain, even if you’re not. That is the first time that stigma takes hold. You become an un-person whose feelings are ALL imaginary until proven otherwise. One time in the hospital I accused someone of stealing my radio. They dismissed me and told me I didn’t have a radio – until I broke into his nightstand and pulled it out. They confiscated the radio because it was “dangerous”.
It can be dangerous not to listen to a patient. My doctor in the hospital insisted I was hearing voices. I kept telling him no. I really wasn’t hearing voices. It’s as if he got my chart mixed up with someone else’s. And guess what he did next? He prescribed an anti-psychotic that gave me seizures and caused temporary blindness. He should have just given me Lithium.
Thus far, I have shown what stigma can look like in the hospital. I will now explain how it looks on the outside.
While in the hospital, rumors spread, some true, that I was locked up for a mental illness. A few people got second hand accounts that I was dead. In any case, my network of friends were all aware that something had gone terribly wrong. I was “crazy”. I was extremely fortunate to have so many friends who were non-judgmental, or at least trying to be.
But here’s the rub: I was extremely judgmental of myself. I adopted the worst case attitude towards my illness. Something was terribly wrong with me, and it was my fault. I was surrounded by other people in crisis who felt the same way. We fed into each other’s self-esteem issues. It continued after the hospital while in transitional housing. I dreaded people knowing what had happened and what I was going through. I pretended it wasn’t happening. I sought comfort and reassurance in the deadly embrace of narcotics. The stigma wouldn’t go away not just because society looked down on the mentally ill, and not just because I was perpetuating the negative attitude; it continued because I added fuel to the stigma fire with hard drugs.
After I got clean, I was battling the stigma of ‘dual diganosis’. Now not only did I feel shame for having suffered a mental breakdown, but then I was feeling even more shame for having sought to medicate the unnamed feeling. The truth is that there are external factors (societal blame, odd behavior) and internal factors (shame, guilt) that create the phenomenon we know now as ‘stigma’.
What did that look like for me? It meant sitting through AA/NA meetings feeling like they were lucky the speaker just had addiction to deal with. It meant that I refused to host a study group because it would mean asking the cooperative apartment manager for permission, and then everybody would get to meet my mentally ill roommates. I would be exposed. I was terrified of the truth coming out. It didn’t matter that I was getting straight A’s, I was not like everyone else around me. I didn’t feel like a normal college student. If somebody said, “Oh god, that’s crazy”, I would internalize it. ‘Crazy’ was a bad word, but I was unaware of its power over me. The word won.
“Your shoes are insane.” Yes, it’s a compliment, but yes, it also diminishes a person’s tragedy. A person labeled insane suffers. A pair of shoes feels nothing. A pair of Adidas and a psychiatric patient are two very different groups.
It is not possible to ask every member of society to stop saying or doing hurtful things. I can ask that anyone reading this should try to understand what a psychiatric patient is going through. If you break an arm, people sign your cast. If you break your mind, people abandon you. They place you in a new cookie jar, away from the other cookies. They use hushed tones and furtive glances when describing your plight. They assign blame. They try to understand a state of mind that is rarely understood.
Read ‘5150‘ and see if you understand. It was designed to shed light on a very chaotic thought process.