Self-stigma is a burden that is prevalent among people with mental illness, says Robert Lundin, a Chicago-area mental-health worker and writer who began having delusions in his 20s and was later diagnosed with schizoaffective disorder, a combination of schizophrenia, mania, and depression. “The diagnosis [and subsequent hospitalization and treatment] left me with a very difficult feeling of failure,” he recalls. “Your life does not go well at all when you get these illnesses.” But, he adds, “there would be no stigma if I had diabetes or heart failure.” Lundin is, in fact, a colon cancer survivor, and has no feelings of stigma associated with having had cancer.

How Self-Stigma Works

Self-stigma occurs when patients agree with and internalize social stereotypes. It tends to affect them in three ways, says Amy Watson, PhD, assistant professor of the Jane Adams College of Social Work, University of Illinois at Chicago:

•Patients often think that their illness is a sign of character weakness or incompetence.

•Patients develop feelings of low self-esteem and become less willing to seek or adhere to treatment.

• Patients anticipate that they will be discriminated against, and to protect themselves they limit their social interactions and fail to pursue work and housing opportunities.

Some of these stigmatizing assumptions come from society at large. Lundin, who is single and dating, recounts meeting a woman online recently who “dropped me like a hot potato” when he revealed his mental illness to her. Others come from a more surprising source: mental-health professionals themselves. Catherine Kahr, a Portland, Ore., mom and student who suffers from major depression, recalls being hospitalized for a suicide attempt and having her psychiatrist lecture her on the street value of her medication. The assumption, she says, was that she was turning around and selling the drugs her psychiatrist prescribed!

“I think a lot of mental-health professionals do contribute to self-stigma,” says Watson. “Ive heard from some who tell their patients, ‘lower your expectations, ‘dont try to go to back to school. They often dont tell their patients to go for the gold.”

Addressing Self-Stigma

While there are no proven ways to alleviate self-stigma, Watson says raising the issue of self-stigma and countering inaccurate stereotypes is the first step. “The more awareness there is of mental-illness stigma, the less it is perceived as legitimate,” she says. She also urges mental-illness patients to use cognitive tools, such as challenging their own assumptions about what they are capable of and not listening to internal stereotypes.

Most important, say experts, is to find a support group and associate with them as much as possible. “If you associate with people who think your illness is taboo, you will too,” Lundin says. “If you associate yourself with a broad marketplace of people who are compassionate about your condition, it makes all the difference.”

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