by Kelly C. Kirby, MS, LPCC
I oscillate between thinking of my bipolar disorder diagnosis as my enemy and my partner in life. When I reflect on this ideological difference, I wish I could blame external events or influential people for my shifting perspective; however, I know that my focus changes most drastically because of self-stigma.
Self-stigma exists for many individuals dealing with bipolar disorder and can take many forms. For some, it prevents them from seeking help from support personnel or organizations. (http://www.disabilityrightsca.org/pubs/CM0401.html) For others, like me, it greatly impacts their relationships with people in their own lives.
I try very hard to manage my symptoms and be successful in my career. Because I work as a licensed professional clinical counselor at a university and in private practice, maintaining my mental health is imperative to my professional success. Most days, I am proud of myself for working in this field and for being in control of my symptoms.
The clouds roll in, though, and I can quickly turn on myself. My thoughts change from "I'm doing well" to "I'm going to fail" sharply and almost without notice sometimes. The thoughts are phonetically similar, which I like to believe is part of my expertly trained version of self-stigma. If I could always catch that first thought, I might be able to stave off what comes next, but it is so subtle.
The thought that causes me the most difficulty is "I can't handle this." Once I'm there, self-stigma strongly settles in. I begin to doubt my loved ones and their intentions, believing that I need to "protect them" from my thoughts and feelings. I consider that others in my profession judge me for having this diagnosis and suddenly feel like I need to compensate in some way; I will take on extra work or create a new project for myself, all in an effort to "prove" that I "still have worth" in some way.
When I'm in this state, it is harder for me to rely on my own perceptions so I seek out external feedback about my decisions, presentation, and general behaviors. This is a catch-22, though, because the self-stigma causes me to work four times harder at appearing "normal" to those around me. Those closest to me have often provided me the insight that they thought maybe something was "off" but had no idea how bad it may or may not be.
I withhold feelings from people because at some point, I ingested the belief that people don’t want to be bothered with them, that my mental illness (and only mine) doesn't need attention or support, and that it is on me to "fix" whatever is wrong. I live in fear that everyone around me will wear out from having to deal with me so I create a system where they rarely have to, even when things reach a critical point.
The cost of this is steep. When I don't allow my support system the opportunity to help me, I am damaging those relationships and hurting myself in the long run. Trying to be a superhero version of myself is exhausting and I always run out of energy long before I run out of ideas. The shame and hopelessness I experience locks me in a space where I don't even know how to trust myself to make decisions or label my feelings accurately.
The juxtaposition of this flood of self-generated insecurity with my career is the very definition of self-stigma. I advocate daily for my clients to decrease the stigma in their own lives, to reach out for help, to help them understand that their feelings are valid and need expressing, and that their support system exists for times like these. I spend immense amounts of time in therapy addressing and helping my clients to reduce self-stigma and promoting self-validation.
I would venture to say that the most rewarding part of my job is helping people to do everything that, in these dark periods, I seem incapable of doing. The secret, though, is that I know I am capable of doing it, that at any time I can look at someone in my support system and say, "I'm not doing great," and trust that together, we can decrease the stigmatized self-talk.
I may not be able to eliminate self-stigma altogether, but I do believe that I can curb its impact by listening to myself when I advocate for others, expressing feelings to my support network, and trusting that my experience is real, valid, and worth knowing. That seems to be the prescription necessary to put a dent in self-stigma; it’s the one that I recommend to my clients, so it's the one I will use, too.