Let’s imagine for a second that you suddenly came down with a physical ailment. How would people treat you? Like if you got a migraine headache. Or you had a stomach ache. Or perhaps more serious, if there was a problem with one of your kidneys? In all likelihood, one of the most common responses would be that of compassion. They would see you in pain and thus their heart moves on behalf of you. Now imagine you’re stuck in an important team meeting at work and a raging stomach ache comes on. Everything in you is telling you to rush out of the room, but you do so at the risk of coming across as rude. You don’t want to be seen in a negative light by your co-workers. But you’re about to poop your pants. How painful would it be to hold all that in and suffer in silence? The reality is, if you interrupted the meeting and said, “I’m feeling sick” you would be met with immediate compassion and understanding. The point is this: in the majority of scenarios, you’re not going to get put into a box or stigmatized because something isn’t right with you physically. You can openly tell people you’re going to the doctor, taking medication, getting treatment or doing weekly physical therapy. No one would treat you differently. The same cannot be the same for mental health. There is still a tremendous amount of mental health stigma that exists around the world. But why? How did we get here? Why is it so much harder to say I have bipolar disorder than I’m a type 2 diabetic? Why is it taboo to say I’m feeling anxious, but not I’m feeling physically ill? There’s many reasons why we got here. Some will shock you, some will anger you and some will downright motivate you to be a catalyst of change. So let’s get into it.

If you’re part of generation Z, those born between 1997 and 2012, this may seem like a non-issue. It’s widely documented that Gen Z is more open about their mental health issues. For them, there is a small fraction of mental health stigma that exists amongst peers. A recent report by the American Psychological Association outlined how, “[Generation Z] is significantly more likely than other generations.. to report their mental health as fair or poor.” Digging a little deeper, we discover that this shift around mental health awareness started with millennials and has continued to be fully normalized by Generation Z. The problem is, an age divide still exists. For older generations, mental health stigma is still very much a thing. And because of this, it’s easy for younger people to demonize older folks. But we must remember, they didn’t choose the time and place in which they were born into history. They were born into a culture where it wasn’t normal to talk about your mental health. How is this their fault? For men specifically, they were taught rather unhealthy ideologies of what it means to be a man. Namely, it’s not okay to share your feelings. You need to be strong and tough. Don’t be a pussy. This reflects in the numbers. In 2021, R/GA Health conducted a survey with 2,500 Americans of varying ages. They found that, “Just 4% of Boomers (as well as 4% of retired people) in R/GA’s study reported seeing a therapist or psychiatrist in a typical year, less than a third the likelihood of the next-lowest age demographic, Gen X (16%), andless than a quarter of millennial and Gen Z respondents.” This is of no small statistical significance. As of 2020, there were 92 million people living across the Greatest Generation (born before 1928), the Silent Generation (1928-1945) and Baby Boomers (1946-1964). If the findings in this study scales, that means just 3.6 million of that number thought it was okay to see a therapist.

When it comes to mental health, one of the most prominent aspects that existed in previous cultures is the heavy emphasis on shame as a motivating tool. This is still very much in existence, for some people groups more than others. To understand this further, we must examine the culture of different people groups. “For some Asian Americans there’s a real sense that your value as a person depends on your ability to take care of your family and community,” says Geoffrey Liu, a psychiatrist at McLean, a Harvard Medical School affiliate.

The McLean report continues, “Asian Americans fear being thought of as weak or “crazy” for having a psychological disorder—perhaps more than any other group. Shame and embarrassment force many to struggle in silence and never seek help.”

In a previous blog, we outlined how sparse mental healthcare was around the globe, particularly in nations like Afghanistan, Egypt and Ghana. It’s not something prioritized by the government and for many people living in non-Western countries, it’s not even a conversation. The West has a significant way to go with the mental health conversation, but at least we’re talking about it. Shame is so riddled in the minds of non-Westerns and the fear of being seen as weak or disappointing their family, that they consider it inappropriate to even bring up. It’s no wonder there is great disparity amongst racial groups when it comes to seeking help. White people are far more likely than their Black, Latino or Asian counterparts to use mental health services.

As we consider shame culture, one of the byproducts of mental health stigma are the false stereotypes that are produced about those who are struggling. In addition to being seen as weak or crazy, the media portrayals of mental illness have not helped. Consider obsessive-compulsive disorder (OCD) and bipolar disorder, for example. The phrase I’m so OCD has become a common cultural saying in the West, usually referring to our incessant need for cleanliness or organization. But this is a gross caricature of what OCD actually is and how debilitating it can be for sufferers. There are over at least 300+ known subtypes of OCD, to which fears around cleanliness and organization represent less than a percent of those subtypes. But the false stereotypes would have you thinking everyone who has OCD is at best a crazy neatfreak and at worst, a mentally unstable person that can’t control themselves. You’re so bipolar is another common cultural saying, flippantly referring to someone’s perpetual mood-swings. Again, it paints this picture of mental instability and weakness. In fact, some research has suggested that the opposite may be true. Those who suffer from OCD and bipolar disorder often have higher levels of intelligence and creativity, which they can put into practice if they learn how to function well with the disorder. Consider this: Albert Einstein, Andy Warthol and Leonardo DiCaprio are highly influential figures in the history of science, art and film. Yet all of them are suspected to suffer from some sort of mental illness. Part of the issue with false stereotypes is education, particularly in non-Western countries. We need a renewed focus on awareness and educating people about what causes mental health issues, how it manifests, what it means and how we can help treat it. As it stands, false stereotypes only serve to further perpetuate mental health stigma and bring greater suffering onto humanity, as we operate in the dark filled with shame. We should be able to tell people we’re clinically depressed, without being stigmatized for it and put into a box. We should be able to let someone into our Schizophrenia diagnosis, without the fear that they won’t want to be around us if they knew.

Due to mental health stigma, there is a genuine risk for social alienation if we decide to let someone into how we’re feeling. There are spaces that don’t feel safe to share. Consider, if you tell someone you have been diagnosed with OCD or bipolar during a job interview, will they write you off as unqualified?

If you confess to your anxiousness in the locker room, will the boys never let you know the end of it? Will you be made fun of and alienated during the following weeks?

Will your parents see you as weak? Will they think you’re less than capable? These are all real issues we face when deciding to be vocal about our struggles. Consider the case of Ben Simmons, a star basketball player for the Brooklyn Nets. While there has been much drama around his trade to the Nets from the Philadelphia 76ers, Simmons has been vocal about his struggles with mental health. This earned him the glowing review from sports analyst Stephen A. Smith: “Ben Simmons might also be the weakest, most pathetic excuse for a professional athlete we have ever seen in, not just American history, but the history of sports. I can’t think of a professional athlete that has come across more pathetic than this man.” Strong language. Comments like this will only perpetuate more hate for a public figure such as Simmons, who will inevitably say he’s using his mental health as an excuse. It’s already happening. Just scroll through his social media feed. Despite the nuances of Simmons’ specific situation, the message is clear. Being vocal about your mental health issues might cause you to become socially ostracized, mocked and/or seen as weak. Suffering itself is painful and we only serve to amplify that pain if we dismiss people’s struggles as not “real” struggles. Yes, anyone can take advantage of a physical or mental health diagnosis for the wrong reasons. But people deserve the benefit of the doubt and they deserve our compassion. We should not be seen as less because we are struggling with our mental health.

A real danger exists for those of reading through all the reasons for mental health stigma and that is to use this knowledge to lash out at specific people groups. Yes, it’s healthy to have righteous anger about the issue. Things need to change. But we also need to wrestle with injustice in a healthy way. We have to build bridges, not walls. And that means sometimes the conversations with other people might be difficult. They may not see what you see immediately. In fact, we’re working against centuries of indoctrination when it comes to the perception of mental health. It will take time to change the narrative. Be patient with older family members and generations. Here are a few practical steps we can take as we seek to change the mental health stigma that exists in our society.

1. Education: One of the primary ways in which we can create change is to educate others on the causes of mental illness, the unique challenges we face and the common misconceptions we’ve discussed in this blog today. 
2. Influence: We can educate others both through 1-on-1 conversations, but also by using your platform and influence publicly to raise awareness. While there are many drawbacks to social media, this is a redemptive way we can leverage it.
3. Clarification: When you’re having a conversation with someone and they say something insensitive or incorrect about mental health, don’t be afraid to correct them. Humbly, of course. They may not know what they’re saying is insensitive or incorrect and if we try to correct them in a self-righteous manner, it will only serve to alienate them.
4. Boldness: You may be reading this today and feel as though it only confirmed fears around sharing your own personal mental health struggles. Don’t be afraid to stand up. We are with you. Others are ready to stand next to you. Change is created over time, through a collective effort. Be the bridge.

 None of these steps mean it’s always going to be easy. In fact, sometimes the conversations will be really hard and emotionally taxing. Which is why it’s okay if you feel like you don’t have the emotional space to become an activist on the mental health front. There is still great reason to hope, which we outline in our closing comments in a previous blog. Know that you are seen, you are loved by God and you are not alone in your struggles with mental health. It may feel dark right now, but there is light at the end of the tunnel.