Fighting Internalized Stigma and Changing My Attitude

In 2011, when I was diagnosed with major depressive order and generalized anxiety disorder during my first semester of college, I wasn’t exactly surprised. Mostly, I was relieved to have an explanation. The diagnoses felt like a validation of the sleepless nights, unexplainable chest pains, spiraling thoughts, crushing despair and constant exhaustion. There was a name for — and a reason why — someone with an objectively good life couldn’t manage to get out of bed and face reality every day.

But as I scanned the insurance paperwork (which was marked with specific numbers corresponding to diagnoses) and reviewed the slip of paper prescribing medication, I felt a lump in my throat. I wasn’t sure how to share this information with those closest to me. Would they see me differently? Would they say I was unstable? Or “crazy”?

Friends and family had expressed concerns about my behavior in the past — the hyperventilating, the constant fear of the future, the days spent in bed — but having an actual name for this behavior felt so official. So clinical. How would I convince my friends, family, potential partners, teachers or future bosses that I was trustworthy? Or capable? Or normal?

To Cope with My Discomfort, I Resorted to Cheap Humor

To manage my anxiety and depression, I began attending therapy sessions regularly and taking daily medication. These changes to my routine were lifesaving; my problems didn’t go away, but they suddenly felt manageable. I even developed specific coping mechanisms to address my panic attacks and depressive spirals. Still, despite the obvious improvement in my day-to-day life, I was embarrassed about the new label I’d been saddled with. My face flushed when my roommates caught me taking pills in the morning, and I found myself scanning the street outside my therapist’s office, terrified of seeing a familiar face.

To ease my own discomfort (and what I assumed to be the discomfort of others) I mocked myself mercilessly. By addressing the elephant in the room, I reasoned, I was protecting myself. Maybe a harsh word or an unsolicited opinion about my mental health would hurt less if I said it first. So, I made sure to call my daily medication “my crazy pills.” I consistently referred to myself as “emotionally unstable,” “chemically imbalanced” and, in the opening line of a dating app profile, “a hot mess of DSM terms.”

My Attitude Only Made Things Worse

Throwing around careless language, I quickly realized, did not make me feel better. My anxiety escalated as I tried to read people’s facial expressions and over-analyzed their reactions when I mentioned my mental health. The more I tried to eliminate the awkwardness, the more negative attention I drew to myself. And I certainly wasn’t putting anyone else at ease. Friends and strangers alike usually stared at the floor, unsure of how to respond, when I made a joke about my mental illness.

Moreover, my toxic approach to addressing my own situation emboldened those who were not as well-intentioned to use similarly offensive terms. I was taken aback when a classmate referred to his partner as “certifiably insane” and winced when another joked about how her mother needed to be “committed to a psych ward” for her constant text messaging. But how could I expect them to speak carefully or respectfully when I consistently referred to myself as “a lunatic”?

I Decided to Change My Behavior and Normalize My Experience

After several months of making jokes at my own expense (and, of course, unpacking this behavior in therapy), I realized that the stigma and judgment I feared was not coming from those around me — it was coming from me. My offensive quips to cut the tension only perpetuated negative stereotypes about mental illness. They also made otherwise normal conversations awkward and tense. So, I made a concerted effort to change my approach.

I began talking openly about therapy with my friends, even sharing valuable insights my therapist had given me when it was appropriate. Eventually, I had offered so much advice that I became a resource to friends who needed strategies for managing stress. “Thank God for your therapist,” one friend joked. “She makes all of our lives better.”

I also began referencing therapy in a casual way, much like how my friends talked about their various medical appointments. When comparing schedules to organize a group outing, we planned around Katy’s wrist MRI and my therapy appointment. Over time, my mental illness became a medical issue as mundane as any other.

Years later, as the national conversation about mental health has continued to evolve, many of those friends have begun therapy themselves. And talking about our mental health now feels as comfortable as talking about what TV shows we’re watching. It’s one small part of who we are — and it carries no connotations of “craziness” or incompetence, like I once feared.

Now, I Find Ways to Speak Up

While I am extraordinarily lucky to have a community that understands the reality of mental illness, that doesn’t mean that everyone I encounter has risen above the pervasive stigma. Sometimes, making progress requires having tough conversations.

Perhaps the hardest part of combatting stigma is having difficult conversations with the people you see regularly. However, I’ve found that being gentle and honest is an effective way to start. I’m open about my mental health conditions and I’m happy to answer questions that people have. If I hear someone using the careless language I once used, I take the opportunity to share my lived experience.

Change doesn’t happen overnight. But looking inward has been a great place to start.

Margot Harris is the Associate Editor of Marketing and Communications at NAMI. She has an MFA in nonfiction writing from Columbia University and previously worked as a digital culture reporter at Business Insider. She lives in Washington, D.C., with her very energetic emotional support dog, Lyla.