ENDING THE STIGMA: Three Es may foster willingness to ask for help

In the midst of a global mental health crisis, why aren’t more people asking for help?

Over 50 million Americans are experiencing a mental illness (21% of the population), according to the latest 2023 surveys. Fifty-five percent receive no treatment (28 million Americans). 

Anxiety disorders are the most common mental health condition in the U.S., affecting over 40 million adults ages 18 and older. And while highly treatable, only 37% of sufferers actually seek treatment. 

So what’s getting the way? Surveys show that the leading barrier to help-seeking behaviors is the shame and stigma surrounding mental illness.

We are stuck in a stigma quagmire that must be examined and eradicated as a public health emergency and priority because, at its worst, mental illness can be terminal if left untreated. At its best, neurodiversity can be celebrated as a unique way to internalize and experience being human.

I recently suffered major injuries to my LCL and ACL — ligaments in the knee that heal very differently. The LCL has sufficient blood flow to heal itself over time, while the ACL has little blood flow and will not heal on its own. It requires a lot of additional support. 

I had a decision to make when diagnosed. My body was broken and needed help to heal and be whole again. If I refused that help — surgery to replace my ACL — I would be physically compromised for the rest of my life. Similarly, not all mental health issues need additional support. But many, if left untreated, can be debilitating.

Soon after surgery, my naked knee was completely unrecognizable. I stared hard at its “brokenness” and felt only compassion and gratitude. I wanted to take the best care of it and asked for help freely, which others happily provided.

I wish I’d felt the same when I’d looked in the mirror — consumed with anxiety, panic, even dissociation — and felt similarly unrecognizable. Ashamed of what I saw, I was paralyzed when considering how to verbalize my brokenness and ask for help.

When I asked my surgeon if my knee would ever look the same, he replied, “Don’t worry. Your knee is under there. This swelling is normal and will recede. You’ll find your knee again. It just takes time and therapy.”

Hmm. With all due respect to therapists, no one ever said that to me when I was sitting on their couch. “Don’t worry. Anxiety and depression are normal. You are still in there, underneath it all. It will just take time and therapy.”

On my last visit to my surgeon, he explained that I was still in the period of “regrowth,” when my body uses the cadaver ACL as scaffolding to build a new ACL around it. That fascinated me. My body was rebuilding because I had given it the support it needed to heal.

And I had scaffolding of sorts all around me. I was surrounded by supporters who opened doors and rooted on my recovery. They held me up until I was physically able to stand alone again.

Looking back, my experience with mental illness was completely different. There was no compassion, only fear and shame. How did this happen? How would I find my way out?

I abandoned myself and adopted the societal stigma that I’d been taught. We abandon our voice, our well-being, our deep knowing that something is wrong, and we need help.

Instead of reaching out, I isolated myself. Instead of using my energy to heal, I used it to hide. Instead of exposing my broken pieces, I tried, with white knuckles, to measure up and cover my cracks with perfectionism and achievements.

We are not born believing we shouldn’t talk about our uncomfortable and scary thoughts and emotions. We are taught this when we hear words that don’t match what we clearly see and deeply feel — words like “everything’s fine,” when it so obviously and painfully is not. Or being dismissed with “you’re fine” and “everyone feels that way.”  

Here are three ways we can start chipping away at this seemingly impermeable stigma:

Empathy: It’s hard to sympathize with what we’ve never felt. We can increase empathy in those who have never experienced mental health issues by encouraging sufferers to tell their stories. Give them a platform and a microphone. Then listen without judgment or consequence, only curiosity and compassion. 

Education: It’s hard to believe what we can’t see. Educating people on mental health and illness will bring a better understanding, which is a crucial component to incorporating the social scaffolding we need to support those who are struggling.   

Empowerment: It’s hard to approach a situation where we feel helpless. Most prefer to ignore it. Giving people the tools and techniques to help can not only empower them, but build a connection between someone struggling and those who want to help.

The more we can normalize these conversations, educate ourselves and empower each other, the quicker we can end the stigma surrounding mental health. This is my goal.

I hope that together we can create a safe and supportive environment that provides the social scaffolding needed by our friends and family struggling with mental health issues.