The Cost of Internalized Stigma

One of the most insidious kinds of stigma people with mental health conditions face is self-stigma. When you’re surrounded by a culture that stigmatizes mental illness, it’s natural that these attitudes can affect the way you see your own mental health. When people with mental health conditions adopt stigmatizing attitudes toward themselves, psychologists refer to this as self-stigma or internalized stigma.

For people with mental illnesses, the costs of self-stigma can be high. For example, more self-stigma is associated with more suicidal ideation. And it’s linked to lower quality of life by way of lower self-esteem.

Internalized stigma doesn’t just amplify the effects of mental illness and hurt people’s quality of life. It also complicates the treatment process.

People with higher internalized stigma tend to have lower self-esteem and less insight, which in turn results in being less oriented toward recovery from mental illness. Moreover, people with more self-stigma take a less active and critical role in their own treatment. They’re more hesitant to express their views, and they’re less likely to voice reservations about their treatment or disagreements they have with their doctor.

Because internalized stigma simultaneously makes the effects of mental health conditions worse and makes treatment harder, figuring out how to counter self-stigma is a big problem for psychologists and psychiatrists.

It appears that this may be a case of knowledge is power. Programs that educate people and give them information about their mental health conditions have shown promise in reducing internalized stigma.

Peer mentoring may also help. For example, one study found that a “peer education” program in which older adults with depression met with other older adults who had previously been treated for depression was effective lowering self-stigma.

Of course, the ideal way to get rid of self-stigma would be to reduce stigma in society at large. The less our culture promotes stigmatizing attitudes toward mental illness, the less stigma there is for people with mental illnesses to internalize in the first place. In the short-term, though, internalized stigma is a pressing problem that sabotages treatment, and anything that helps people free themselves from stigmatizing attitudes toward their own mental health conditions will make it easier to live with mental illness.

Image: Flickr/Amy Messere