How Does Stigma Affect Mental Health?

Written by Steve Rose

Steve Rose, PhD, is an addiction counsellor who assists those struggling with substance abuse, gambling, gaming, and internet addiction.

Persons with mental health or addiction issues often deal with stigma. In turn, stigma negatively affects mental health. This downward spiral makes it harder to seek treatment, leaving people feeling even more socially isolated.

Stigma consists of a label used to exclude an individual, causing them to internalize this label as part of their identity. They generally consist of labels based on negative stereotypes about a specific demographic. For example, the word “junkey” can be stigmatizing for persons with an addiction. So how does this affect someone’s mental health?

Stigma affects mental health by inflicting further harm on already vulnerable populations. A person may internalize a stigmatizing label, causing further isolation, distrust, and low self-esteem, resulting in increased anxiety or depression. 

Anxiety is the fight or flight response to stigma, whereas depression is the purposelessness and hopelessness resulting from this downward spiral.

In this article, I share the experience of Stephanie, a fellow recovery advocate who experienced a great deal of stigma during active use and recovery.

How Stigma Triggers Anxiety 

Persons already suffering from mental health or addiction issues often experience anxiety. A stigmatizing social environment amplifies this anxiety. As Stephanie states:

“When I got off the drugs my anxiety went right through the roof. It told me I was a mess and no good and that it would be years before I ever was trusted or treated “normal”. When people stigmatized me, it confirmed those anxious thoughts for me. A lot of my recovery work has been on my anxiety. It was bad before I used, but after it was worse.”

While in a vulnerable state of recovery, she had to navigate family, friends, and professionals who treated her differently due to her addiction. She states:

“It’s not so much what they said as how they treated me. They were cold and avoided conversations with me. There were a lot of snide comments about how I should make better choices… everybody wanted to make sure I understood how much I hurt the people around me… they didn’t seem to think I knew.”

This sense of being different from everyone else leaves a person feeling isolated. Without a sense of social support, persons who are already vulnerable experience increased anxiety, particularly in social situations. As Stephanie states:

Social situations could mean answering a lot of questions based on stigmatic things people heard and believed about addiction. It could mean people talking horribly about me because of the life I previously led. It could mean running into people from my past that could tell others around me that didn’t know… because of the stigma and negative perceptions, I had horrible anxiety when having to go into social situations. Until I was strong enough to use an education “shield” to deflect the anger towards the stigma and educate the person using the stigma, I would avoid all social settings at all costs.

As the isolation and anxiety spiral further, it makes it increasingly difficult for a person to pull themselves out of this difficult place.

How Stigma Affects Identity  

As stigma takes over one’s identity, a person begins to internalize stigmatizing labels. This process can also be called “self-stigma”. The labels become anxious thoughts, replaying like a broken record. Stephanie’s mind raced with self-stigmatizing thoughts:

“You are a fuck up… You cant do this… You are not good enough… No one likes you… You can’t work… You’re stupid… You won’t get better… You will never stop… No one will take you seriously… Everyone is better off without you…”

This self-stigma is further reinforced when interacting with others who make off-handed remarks regarding any of these anxious thoughts. Stephanie felt like she was living in a constant state of judgment:

“It made it worse and harder to navigate the world. I was afraid that everyone would hate me. I was always second-guessing everything I did and how people perceived me.”

This prevented her from being able to reach out for help. Living in this state of anxiety led her to believe there was no way out:

“I was hopeless and believed that I would not be able to get help. In my own head, I was a lost cause.”

What Stigma and Anxiety Have in Common

Stigma and anxiety are both based on fear. We fear the unknown, and a person using stigmatizing language often does not know or understand the experiences of those they stigmatize. 

Beyond the realm of mental health and addiction, we can find a great deal of stigma in the politics of immigration. Before the pandemic captured all of the headlines, immigration was one of the biggest global issues. This included issues like Brexit, Trump’s statements regarding Mexicans and other minority groups, and the surge in nationalism. 

Stigma does not often come from true hatred. Even when hatred does exist, the issue goes much deeper. Beyond hate, anger, and frustration, you can often find fear. Immigrants and other minority groups can provoke fear among those who lack familiarity with such groups. 

When we feel threatened by economic uncertainty, fear often gets projected outward as anger. Immigrants and other minority groups often become scapegoats for this fear. 

Now, more than ever, we need to keep our fear in check. As we navigate a world full of heightened fear of contagion, we need to consider the humanity of others, rather than resorting to broad stigmatizing labels. 

Conclusion  

Stigma affects the mental health of persons who are already vulnerable by further instilling a sense of social isolation. This social isolation increases social anxiety, potentially leading to internalized self-stigma. Self-stigma makes recovery increasingly challenging as it becomes reinforced by others, leading to further marginalization and a sense of hopelessness.

Recovering from stigma requires separating yourself from the negatively spiraling self-reinforcing thought loops. Rather than identifying with a self-stigmatizing thought, greet it like an old friend, welcome it in, and tell it you have more important things to focus on right now. Then focus on those more important things, letting it be.

Recognize persons who perpetuate stigma are often doing so based on fear or ignorance. Their reactions to you say more about them than about you.

Lastly, stigma makes it difficult to trust others enough to reach out for support. This is a large part of what kept Stephanie stuck in her addiction. When she gained the courage to reach out for help, she broke the power of stigma, finding a supportive treatment facility. Through the support of staff at Aegis Health Group in Windsor, Ontario, she was able to rebuild trust, coping skills, and the confidence to succeed in her recovery.

Unfortunately, many people do not encounter supportive professionals the first time they reach out. Like so many others, Stephanie had to reach out to various sources before finding the right fit for her. If you have been unable to find the right support, persistence will likely pay off when you find the right fit. I discuss this topic further in my article here.

If you would like to learn more about Stephanie’s story of recovery from addiction, you can find it in my article here. If you want to reach out to her, you can contact her on her personal Facebook page here.

Looking for General Support?

BetterHelp.com provides online counseling. Check out their site here to see if their services are right for you Their main benefit is lower costs, high accessibility, and the ability to switch counselors quickly and easily if you don’t feel supported.

Online-therapy.com is currently offering free support for persons looking to optimize their mental toolbox. Check out their free worksheets based on the evidence-based practice of Cognitive-behavioral Therapy (CBT).

*As an affiliate partner with Better Help and Online-therapy.com, I may receive a referral fee if you purchase products or services through the links provided.

To find local support, use the Psychology Today therapist directory here.

As always, it is important to be critical when seeking help, since the quality of counselors and therapists are not consistent. Also, one of the most important factors in successful treatment is the quality of the therapeutic relationship. If you are not feeling supported, it is important to seek out another practitioner.

Curious if online therapy works? I wrote an article here, looking at the evidence.

If you’re just bored and looking for a new hobby, check out Skillshare. with thousands of classes to choose from, this online community allows you to gain new skills, network with peers, and find new opportunities. Check out their free trial here.

*As an affiliate partner, I may receive a commission if you sign up for a free trial. 


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3 Comments

  1. Brian

    “…we need to consider the humanity of others…” Very true.

    Thank you, Steve.

    Reply
  2. Donna-Luisa

    Thanks for this …Stigma can be a bigger challenge than the illness for the afflicted. My sister felt it and shared her concerns about how it affected her at work. Indeed it is not good, and not understood. Appreciate you sharing on these topics

    Reply
    • Steve Rose

      Thanks! Glad you liked it.

      Reply

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