Individuals and organizations throughout the world are dedicated to the important work of removing the stigma that affects people with depression and bipolar disorder. Unfortunately, too many of them are replacing one type of stigma with another type that is making the situation worse. While advocating for others to stop judging those who suffer from the conditions, they are causing a self-stigma that increases and prolongs the suffering.
My friend Andy Behrman says, “If we want to eradicate stigma, we must first understand what stigma is: ignorance, fear & discrimination.” Of the hundreds of statements about stigma, this one captures it the best for me. Everything else is an offshoot of these three core problems.
There is certainly an incredible amount of ignorance surrounding depression and bipolar disorder. Even if we were able to clear up the many misperceptions about either condition, there is so much more we need to know to fully understand them. Depression and bipolar disorder affect every part of our lives (physical, mental, emotional, spiritual, social, and career/financial) and most people are aware of only a fraction of any of the parts.
We can be afraid of many things, but the worst fear is of the things we are ignorant of. The combination of fear and ignorance is so powerful that many people think fear is just another word for ignorance. They even have an acronym for it: FEAR – False Evidence Appearing Real. But when we understand fear and the role it plays in our condition, we can use it as a tool instead of letting it destroy us.
When most people talk about stigma, they are mostly concerned with discrimination and the role that ignorance and fear play in creating it. Discrimination holds us back from accomplishing what we are capable of because it robs us of opportunities that are available to others. We end up with a diminished life that is far below what should have been.
I learned about stigma soon after my first diagnosis with bipolar disorder. I began going to support groups to try to learn as much as I could about the condition and was told that I needed to cancel my projects because I was too sick to handle the stress. They said they had been there and could help, but it seems the only place they had been is one of ignorance and fear. They were so sure that bipolar could only result in a diminished life that they presented it as the only option.
I was fascinated by the way everyone saw bipolar, so I visited every group I could find to see if it was what the norm for the bipolar community or just the one particular group. Unfortunately, after visiting every group I could find I could only conclude that “I can’t” is the mantra for almost all of them.
While visiting the group meetings, I saw so many new people leave during the first break that I decided to chase them down and ask why. Almost all of them said they were leaving because they did not want their lives to end up like what was being presented. They came to find hope for a better future, but went away thinking the only thing they could do is learn to accept a diminished life.
My observations were only reinforced when I expanded my search to include groups on the internet. While I did find a few who were advocating the “dangerous gifts” within the disorder, most were sharing their advice on how to survive while in the next sentence describing how the advice has not worked in their own lives. The biggest thing I noticed, though, was the prevalent concept that “survive” is the best we can hope for.
Things have changed dramatically since those early days. Various anti-stigma campaigns have focused the attention on the judgments of others and the recovery movement has solidified the idea that we can only thrive if we reduce the symptoms of mania and depression. We are beginning to see some acceptance of the idea that there are advantages to being bipolar, but the conversation is still dominated by those who insist it is impossible to be bipolar without disorder.
I understand the fear that people have about depression and mania getting out of control. Another crisis episode is the last thing they want to experience again. People who are bipolar, along with everyone around them, live in fear that the next recurrence will end in tragedy.
It is the willful ignorance that amazes me. When we try to share our successes and offer a clear path for others to follow, many refuse to even consider the evidence we present. And that is the stigma that is causing the most harm. The stigma from outsiders is not holding people back nearly as much as those who diminish their own lives out of self-stigma.
We must understand that our beliefs about what we can achieve create the limits of our success. I know from teaching others that most of us can learn to increase our functionality, comfort, and value in an expanded range of intensity in both depression and mania. We do not need to remove bipolar to achieve our potential; we achieve our potential when we no longer see bipolar as an illness to overcome, but an advantage.