Mental health is an essential part of our overall well-being. Yet, for far too long, mental health conditions have been shrouded in misunderstanding, fear, and shame. While society has made strides in recognizing the importance of mental health, the stigma surrounding mental illnesses continues to be a major obstacle for individuals seeking help and understanding. This stigma not only affects how people with mental health conditions are perceived but also how they perceive themselves.
As a psychiatrist, I've witnessed firsthand the devastating impact of stigma on my patients' lives. I've seen people delay treatment out of fear of being judged, lose relationships due to misconceptions, and struggle with their own self-worth because they have internalized society's harsh judgments. It's time to break these chains. In this blog, we'll explore what stigma is, how it affects those living with mental health conditions, and most importantly, how we can work together to tackle it.
At its core, stigma is a mark of disgrace that sets someone apart from others. When it comes to mental health, stigma manifests as negative stereotypes, judgments, and discrimination toward individuals with mental health conditions. It is the false belief that mental illness is a sign of weakness or that people with mental health challenges are unpredictable, dangerous, or incapable of leading fulfilling lives.
Historically, stigma was even more blatant. During medieval times, people with mental health issues were often seen as possessed by evil spirits and were subjected to horrific treatments. They were imprisoned, tortured, or even killed in an attempt to “cure” them. Thankfully, we’ve come a long way since then, but subtle forms of stigma persist in modern society. Today, it's more likely to show up as an awkward silence when someone mentions depression, a reluctance to hire someone with a history of anxiety, or the suggestion that someone just needs to "snap out of it."
Stigma operates on multiple levels. Public stigma involves the prejudiced attitudes that society holds towards people with mental health conditions, while self-stigma occurs when individuals internalize these negative views and begin to believe that they are less worthy or capable because of their condition.
Let me tell you about Sarah, one of my patients who has graciously allowed me to share her story. Sarah is a 28-year-old woman who has been living with bipolar disorder for most of her adult life. For years, she kept her diagnosis a secret, even from her closest friends and family. Why? Because she was terrified of what they might think. In her mind, revealing her diagnosis would change everything—it would turn her into “the bipolar girl” instead of Sarah, the bright, kind, ambitious person she knew she was.
Despite her efforts to manage her condition, Sarah struggled with self-stigma. She often questioned her own worth and abilities. Every time she faced a setback, she wondered if it was because of her illness. Over time, this self-doubt chipped away at her confidence and made it even harder for her to seek the support she needed. The stigma she feared from others had taken root within her, amplifying the challenges she was already facing.
This is the insidious nature of stigma. It doesn't just affect how others see you—it changes how you see yourself. And when you begin to see yourself through the lens of stigma, it becomes that much harder to move forward.
Stigma also has real-world consequences. It can affect nearly every aspect of a person's life:
Understanding the history of mental health stigma helps shed light on why it continues to persist. Throughout history, mental illness has been grossly misunderstood. In ancient times, mental health conditions were often seen as a sign of divine punishment or demonic possession. Those who were mentally ill were subjected to cruel and inhumane treatments, ranging from exorcisms to imprisonment.
One of the turning points came during the Enlightenment when mental illness started to be viewed through a medical lens. Mental health institutions were established to treat individuals suffering from conditions like depression or schizophrenia. While these institutions were a step forward in recognizing mental illness as a medical issue, they also reinforced stigma by isolating patients from the rest of society.
The stigma surrounding mental health wasn’t just a product of ignorance—it was institutionalized. People with mental health conditions were often stripped of their rights, their autonomy, and their dignity. They were seen as “other”—a group to be feared and avoided. This attitude has persisted in various forms, shaping how society views mental health even today.
Why is stigma so difficult to overcome? To answer this, we need to dive into the psychology behind it. One of the most influential theories in this area comes from sociologist Erving Goffman, who described stigma as a process by which individuals are discredited based on some characteristic that is deemed socially unacceptable. In his view, stigma reduces a person’s identity to their condition, overshadowing everything else about them.
Then there's attribution theory, which explains how people try to make sense of the world by attributing causes to behaviors. When it comes to mental health, people often fall into the trap of believing that individuals are responsible for their mental health condition. For instance, someone might think, "If they’re depressed, they should just try harder to be happy." These kinds of thoughts reflect a fundamental misunderstanding of mental illness and reinforce the belief that mental health is a matter of willpower rather than biology and circumstance.
As a psychiatrist, I’ve seen how these attitudes make their way into everyday conversations. Take the example of Mark, a young man who struggled with anxiety for years. When he finally mustered the courage to tell his family, their response wasn’t one of support but of skepticism. “Why don’t you just relax? Everyone gets stressed,” they said. To them, Mark’s anxiety was something he could control if he just put his mind to it. These kinds of reactions are rooted in the belief that mental illness is a choice, further perpetuating the stigma.
The media plays an enormous role in shaping how we view mental health. Unfortunately, more often than not, it reinforces stigma. Think about how people with mental health conditions are portrayed in movies, television shows, or news headlines. They are frequently depicted as violent, unpredictable, or dangerous. This not only distorts the reality of mental health but also creates a sense of fear around those living with these conditions.
Let’s take a closer look at a well-known film: One Flew Over the Cuckoo's Nest. While it brought attention to the issue of mental health treatment, it also portrayed psychiatric patients as outcasts, incapable of functioning in society. Such depictions contribute to the belief that people with mental illness should be feared, pitied, or avoided altogether.
But the media isn’t just a villain in this story. It can also be a powerful tool for change. Campaigns like the UK's Time to Change and others have used media to promote understanding, empathy, and support for individuals with mental health conditions. These campaigns share personal stories, challenge misconceptions, and encourage open dialogue about mental health.
While stigma is deeply entrenched, it is not unbreakable. Over the years, research has identified several strategies that can effectively reduce stigma and foster a more inclusive, understanding society.
I’ve seen this firsthand with Lucy, a high school teacher who used to shy away from discussions about mental health with her students. After attending a workshop on mental health awareness, Lucy began incorporating mental health topics into her lessons. She noticed a significant change in her students’ attitudes—they became more open, supportive, and curious about how they could help one another. By normalizing these conversations, Lucy helped her students become part of the solution.
Consider Tom, a lawyer who, like many of his colleagues, held negative views about people with mental health conditions. That changed when one of his closest friends confided in him about her struggles with depression. Seeing how she continued to excel in her career and maintain her relationships, despite her challenges, changed Tom’s perspective. He realized that mental health conditions are not the defining characteristic of a person.
Protests have been instrumental in changing policies that discriminate against individuals with mental health conditions. For example, many advocacy groups have successfully pushed for mental health parity laws that require insurance companies to cover mental health services in the same way they cover physical health treatments.
As healthcare providers, we have a unique responsibility to combat stigma within our own profession. While one might assume that mental health professionals are immune to holding stigmatizing views, the reality is more complicated. In fact, studies have shown that healthcare providers can harbor the same prejudices and misconceptions as the general public.
I’ve seen it in my own practice. Well-meaning doctors sometimes dismiss a patient’s physical health concerns, attributing everything to their mental illness. This phenomenon, known as diagnostic overshadowing, leads to inadequate care for people with mental health conditions. For example, Angela, a patient of mine who has schizophrenia, was experiencing severe stomach pain. For months, her complaints were brushed aside as “psychosomatic” until she was finally diagnosed with a peptic ulcer. Her mental illness had overshadowed her physical symptoms, delaying her treatment and exacerbating her condition.
We, as mental health professionals, must be vigilant in examining our own biases. It’s not enough to simply treat the symptoms of mental illness; we must also challenge the stigma that surrounds it—both in ourselves and in the systems in which we work.
While stigma is a global issue, so too are the efforts to combat it. Many countries have implemented national anti-stigma campaigns aimed at changing public perceptions of mental health. One such example is Time to Change, a UK-based campaign that encourages people to open up about their mental health experiences and challenges societal misconceptions.
On an international level, the World Health Organization (WHO) and the World Psychiatric Association have spearheaded efforts to reduce mental health stigma worldwide. Programs like the Open-the-Doors campaign, which focuses on reducing stigma related to schizophrenia, have made significant strides in fostering understanding and compassion for those with mental illnesses.
But global efforts alone are not enough. Real change happens at the community level—through conversations with friends, support for family members, and empathy for colleagues. Each of us has a role to play in breaking the stigma.
So, how can you help tackle the stigma surrounding mental illness? It starts with small, everyday actions. Here are a few ways you can make a difference:
Together, we can break the chains of stigma and create a world where mental health is treated with the understanding and respect it deserves. Mental illness doesn’t define a person, and it’s time we start treating those with mental health conditions as whole, valuable individuals with the same rights, opportunities, and dignity as anyone else.
The stigma surrounding mental health may be deeply entrenched, but it is not indestructible. By educating ourselves, sharing personal stories, and demanding change in how mental health is perceived and treated, we can make a difference. As a psychiatrist, I believe in the power of understanding, empathy, and action. The journey toward acceptance and inclusion for those with mental health conditions is ongoing, but with collective effort, we can create a future where stigma no longer stands in the way of anyone’s well-being.
Let’s work together to create a more compassionate, understanding world—one where mental health is treated with the same respect as physical health and where everyone has the opportunity to live their fullest life
TAGS: Public stigma, self-stigma, Erving Goffman, attribution theory, One Flew Over the Cuckoo's Nest, diagnostic overshadowing, Time to Change, Open-the-Doors
Disclaimer:
All characters and events depicted in this blog are entirely fictional. Any
resemblance to actual persons, living or dead, is purely coincidental. The content is intended for informational
purposes only and should not be considered as medical advice. Always consult a qualified healthcare professional
for
medical concerns.
Dr. Saurabh Kumar is founder of Bihar Healthy Minds, specializes in clinical psychiatry, psychosomatic medicine, and expertise in various aspects of mental health. His research explores innovative treatments like Transcranial Magnetic Stimulation (TMS) and addresses stigma and psychopathology in mental illness. You can find Dr. Saurabh Kumar on Facebook , Instagram and Twitter as well.
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