Tell people that you’re having a hard time with arthritis or cancer and you’re likely to get sympathy and support. But mention that you’re struggling with mental illness and you may be met with uncomfortable silence or judgmental stares…you may even wind up losing face or losing friends.

That’s really sad. Yet the lamentable truth is that, despite abundant evidence to the contrary, many misguided people still view depression, bipolar disorder, schizophrenia, addiction and other mental health problems as a sign of a character defect or moral failing. For instance, about 50% of Americans consider depression to be a personal weakness. So it’s no wonder that many people who live with such stigmatized disorders often keep that information to themselves.

But is staying silent the best policy? Not necessarily—particularly if silence exacerbates a sense of isolation or shame or prevents people from getting needed treatment.

It’s important to know when to speak out to friends and acquaintances, according to Bernice Pescosolido, PhD, a professor of sociology at Indiana University and director of the Indiana Consortium for Mental Health Services Research. Dr. Pescosolido has done extensive research on stigma and other social issues surrounding illness. Here are her suggestions for dealing with the ignorant forces that perpetuate the stigma surrounding mental illness.


First, take a good, honest look at yourself—and ask yourself whether you might share society’s biases about mental illness. If you do, you may be trying to ignore your own symptoms—but that can be not only demoralizing but also dangerous if it keeps you from getting the treatment you need. What to do…

Find the courage to confide in your doctor. Yes, it can be embarrassing to say, “I’m having trouble controlling my drinking” or “Sometimes I feel so depressed that I can’t even get out of bed.” Remind yourself that physicians are trained to help patients without passing judgment. If your doctor does make you feel uncomfortable after you describe your symptoms and concerns, request a referral to a specialist or find yourself a more compassionate physician with whom you can openly discuss your condition and your treatment options.

Raise your own awareness about stigma. In a new study published in The Lancet, researchers looked at genetic data from about 60,000 people around the world and discovered that the same genetic “glitches” can eventually evolve, if prompted by other genetic or environmental factors, into one of five different psychiatric illnesses—autism, attention-deficit/hyperactivity disorder (ADHD), major depression, bipolar disorder or schizophrenia. Ask yourself: Considering that so many mental disorders may originate from the same genetic root, why is it that people with ADHD typically can speak so freely and even make jokes about their disorder, while those with schizophrenia, bipolar disorder, depression or addiction often feel ashamed or even guilty?

To help you move past that shame, remind yourself that you don’t need to “self-stigmatize” by buying into the stereotypes, Dr. Pescosolido said. Whenever you do start to feel any self-reproach, tell yourself, There are many happy, productive members of society who are living well with mental illness. We are not to blame for our disorders, and our lives do not have to be defined by or destroyed by those disorders.

It also may be helpful to check out Bring Change 2 Mind, a nonprofit that works to end the stigma and discrimination of mental illness…and Mental Health First Aid USA, a public education program that helps people identify, understand and respond to signs of mental illnesses and substance use disorders.


You will feel less blameworthy and more confident speaking to others about your condition if you are knowledgeable about it yourself.

Do some research on your disease. When looking online, though, beware—rumors and half-truths abound. Stick with reputable Web sites such as those from the National Alliance on Mental Illness and National Institute of Mental Health…and sites affiliated with major hospitals, such as Mayo Clinic or Massachusetts General Hospital.

Join forces with fellow patients. An advocacy or support group provides the kind of understanding and insight that only people who share your condition can offer. To find such a group, check the Mental Health America’s referral service. Examples of groups that offer online and/or face-to-face support include Depression and Bipolar Support AllianceSchizophrenia and Related Disorders Alliance of AmericaAlcoholics Anonymous…and Narcotics Anonymous.


Our society has come a long way since the days when people with mental illnesses were locked away in “lunatic asylums” for the rest of their lives. But we still have a ways to go to get rid of stigma. The more freely patients are able to talk about their illnesses, the more understanding the general public may become. Nonetheless, the decision about whether and when to speak out about a stigmatized disease lies with each individual. While there are no hard-and-fast rules, you’ll want to consider the following points…

With a new love interest: Talking about your mental health on a first date usually is not appropriate. When should you bring up the subject? A good benchmark, Dr. Pescosolido said, would be around the time in a relationship when you would disclose that you have, for instance, some significant debt or carry the gene for Alzheimer’s disease. In other words, initiate the discussion when it looks like a romantic relationship may be about to get serious.

With a casual friend: If you have no desire to deepen the friendship, you may not want to bring up the subject of your mental illness at all. However, if you are interested in forging a closer friendship and you have reason to believe that the other person will be sympathetic and understanding, it’s worth broaching the topic. If the other person responds poorly, try not to be too disappointed, Dr. Pescosolido said—some people can’t handle any type of illness in a friend, stigmatized or not…and that’s not the kind of close friend you need or want. On the other hand, if your friend responds well, your trust will be rewarded because the relationship will reach a new level of intimacy and honesty.