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Stigma

Hear me, Understand me, Support me: What young women want you to know about depression

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Hear Me

You don't want to be seen going into the counsellor's office, you know. It's the stigma. And that has to be removed.

[When I discuss depression,] I use the word disease, and the only reason that I say it is because I'm so tired of having to justify it as a disease. There are these social stigmas around it. I [call it a disease] to validate it as an illness.

I've spilled my guts to entire strangers on the street . . . And yet I can't reach out to my closest friends. I think it's because you're a lot more scared of how they'll judge and criticize you.

In some cultures [stigma is] more pronounced, especially for depression, where it's not really a recognized illness. If you have it, it's not something to talk about. If you have depression, it's kind of like a sign that you're weak. . . . [Services] have to be culturally sensitive.

You tell people, "I'm on antidepressants," and they think, "Oh, you're crazy." It's the stigma. It's the lack of information, the lack of education.

Maybe it would help to educate the public, rather than focusing on the actual depressed people - opening the minds of those who aren't depressed so that they're not so judgmental and closed-minded.

Understand Me

Stigma refers to the negative "mark" attached to a person who possesses any characteristic or illness that marks that person as different from "normal" people. This "difference" is viewed as undesirable and shameful, and can result in people having negative attitudes (prejudice) and negative responses (discrimination) toward another person. 1

Stigma is a serious impediment to the well-being of young women. It affects young women while they are depressed and while they are healing, and can last long after they feel well again. Stigma keeps many young women from seeking help and results in a tendency to keep feelings secret. It can lead to negative feelings about oneself (self-stigma), social isolation, a constricted social support network, a loss of hope for recovery and sometimes even suicide. 2

The young women identified stigma as being a barrier to seeking help for their depression. They are afraid that others will judge them, so they are reluctant to talk about their feelings. Some young women talked about the stigma associated with depression and others spoke about the stigma of using services in the mental health system. The young women told stories of the negative reactions they received from others when it was discovered that they were on antidepressants.

A common fear was of being labelled "crazy" and being treated differently because of that label. When language is used to stigmatize, it is hurtful and can lead to discrimination and exclusion, and it reduces the ability of people to live, work, seek help and recover in the community.

Support Me

People from all walks of life experience mental health problems such as depression, including famous people such as writers Emily Dickinson and Virginia Woolf, Olympic figure skater Elizabeth Manley, actors Margot Kidder and Brooke Shields, Ontario's Lieutenant Governor James Bartleman, retired general Romeo Dallaire, NHL player Ron Ellis and astronaut Buzz Aldrin.

Several factors play a role in helping people recover from mental health problems. These include the type of therapy used (if any); the quality of the relationship between the therapist and the young woman; the hope a young woman has for recovering from depression; and the daily circumstances outside of any therapeutic relationship. This last factor is referred to as the "extra-therapeutic factor" and it contributes 40 per cent - more than any other factor - to the chances of a person recovering.

Extra-therapeutic factors include supportive family and friends, a feeling of belonging and daily interactions with people, including strangers. Extra-therapeutic factors provide many opportunities for people to make a difference in someone's life. But stigma severely undermines this key factor in recovery.

We need to talk about depression to become comfortable with the subject. Education and knowledge go a long way to dissolving fears and misconceptions around depression. The more we know about it, the less likely we are to place judgment on it and the less we are at risk of stigmatizing someone. Here are some things you can do to stamp out stigma:3 

  • Acknowledge the prevalence of mental health problems such as depression.
  • Learn more about depression and the challenges young women face.
  • Try to imagine what it would be like to be stigmatized.
  • Watch for assumptions embedded in your language and others'.
  • Analyze the media and openly critique stigmatizing material.
  • Respond directly to stigmatizing material in newspapers or magazines with a letter to the editor.
  • Speak up about stigma to friends, family and colleagues.
  • Be aware of your own attitudes and judgments.
  • Support organizations that fight stigma.

We all have many opportunities to respect young women and treat them with dignity. This can go a long way toward breaking down the barriers of stigma.

The following resources offer more information on stigma:

Beyond the Label

Centre for Addiction and Mental Health. (2005). Beyond the Label: An Educational Kit to Promote Awareness and Understanding of the Impact of Stigma on People Living with Concurrent Mental Health and Substance Use Problems . Toronto: Author.

This kit includes group activities; master sheets, in print and CD format, to photocopy for handouts or to make transparencies; background information on concurrent disorders and stigma; discussion points for group and individual dialogue; facts and ideas on stigma; examples of opportune times to use the kit with a variety of audiences. See A Critical Link - Print and Other Resources for more information.

TAMI (Talking about Mental Illness)

Talking about Mental Illness is an anti-stigma program for secondary school students delivered in the school through a community partnership of service providers, volunteers and individuals with an interest in mental health issues. The program has two manuals: Community Guide and Teacher's Resource.

Both can be downloaded at http://www.camh.net/education/Resources_teachers_schools/TAMI/ See A Critical Link - Web-Based Resources for more information.

Footnotes:

1.  C. O'Grady. (2004). Stigma as Experienced by Family Members of People with Severe Mental Illness: The Impact of Participation in Self-Help / Mutual Aid Support Groups.  Unpublished doctoral dissertation, University of Toronto.

2.  M. Pompili, I. Mancinelli & R. Tatarelli. (2003). Stigma as a cause of suicide.  British Journal of Psychiatry, 183 (2) 173 - 174.

3.  Adapted from Gibson, M., Munn, E., Beatty, D. & Pugh, A. (2005).  Beyond the Label: An Educational Kit to Promote Awareness and Understanding of the Impact of Stigma on People Living with Concurrent Mental Health and Substance Use Problems, Overhead 15. Toronto: CAMH

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