The Shame and Guilt of Mental Illness

For the last couple of weeks, I’ve been thinking about this blog, letting it really bake before releasing it to the world. What I was really waiting for was some kind of inspiration and anchor to assemble my thoughts to.

Along came Dr. Brené Brown. Dr. Brown is a writer, researcher, educator, and activist. She is an award-winning member of the research faculty at the University of Houston Graduate College of Social Work, where she has spent the past ten years studying authenticity, belonging, and shame, and the effect these powerful emotions have on the way we live, love, parent, work, and build relationships.

I recently spent some time looking at all of Dr. Brown’s videos online and realized that through my treatment and recovery of bipolar disorder I had not been taught how to deal with the guilt and shame I experience on a daily basis.

For 10 years of my adult life I held a secret close and tight to my heart; not letting anyone see the pain, guilt, shame and pure embarrassment I felt for the actions I took before, during and after being diagnosed with bipolar disorder.  This way of behaving impacted my ability to be effective and have social and personal relationships that I could count on.

At work, part of my mind was focused on how could I trick them into seeing me as a great employee? My friends got the version of “Leslie” I wanted them to see. I wish I could tell you that I was interested in their concerns, hopes and dreams, but I wasn’t. I spent all my time and energy trying to look and act “normal”. Because of this behavior,  I missed opportunities to connect with people on a deeper level. Really missed them.  Each time I got to interact with someone at work or in a social situation my mantra was – “don’t let them see the real you, because if they do, you’ll be voted off the island”.

This missing the opportunity reminds me of when I used to play 3- pitch in the 4th grade. In 3 Pitch the pitcher is on your team – talk about upping the odds of hitting a home run!  They pitch in a way to have you hit the ball – but in my case I was just swinging and missing, swinging and missing.  Each time I interacted with someone I would play a different part, a different character. It was mentally and physically exhausting. It was hard to keep up, but I was determined that nobody find out my secret.

The whole act was in service of hiding the real me. My thought process was if you found out who the real me was, the broken me, the less worthy me, the unstable me – you’d change your opinion of me, you would not want to be my friend, you would not hire me or promote me; and you definitely wouldn’t trust me with anything of value.  It made sense to me at the time. Why would I risk anyone knowing the real me?  I needed the evidence to prove I wasn’t broken. If I could hang on to friends, jobs, contracts and gain trust from the people around me it must prove that I am a worthy human being, not broken like my mind tells me.

The foundations of my relationships was faulty and built on lies, half-truths and fear.  I couldn’t see the impact this was having on me or anyone else. It was in one of my “blind spots”.

I’ve been living with these two friends: shame and guilt for a long time. It has been a tedious relationship, one that I have not been able to shake entirely.

My original treatment and recovery plan didn’t focus on these feelings of shame and guilt; No one said that I would have to manage this. No one prepared me for what it was going to be like. Mostly I got support via medications. Feelings of depression were very familiar to me when I came home to live with my parents after spending weeks in Vancouver denying I was diagnosed with bipolar disorder. The solution was an antidepressant, which I’m still on and some psychotherapy that lasted about 6 weeks.

In the therapy we talked about what it was like to be diagnosed – I remember the Dr. gave me the image of climbing a mountain as a comparison in how I was going to have to come to terms with it.  And that’s where it ended. The idea of having to manage the shame and guilt about the illness was never addressed.

We didn’t come up with any strategies to support the shame and guilt I experienced associated with:

1.    My manic and totally out of character behaviors and actions I took prior to being diagnosed. (In my case I was manic, delusional and had psychosis)

2.   The feelings of stigma and shame I feel every time I choose to disclose that I have a mental illness, even if it’s in front of others who have been diagnosed with something similar.  In most families this is kept as a secret, which was the case in mine or at least that’s how I perceived it.

3.   The overwhelming feelings and emotions of being professionally told I’ve been diagnosed with bipolar disorder; in my head I created this as equaling I’m less than someone who is “normal”.

So this weekend I took on writing about the shame and guilt I experience. I realized that over the last 15 years I’ve done different exercises and therapies to support me with managing and dealing with the diagnosis, however I had not done any therapy to deal directly with my feelings of shame and guilt.

Here is the process I took on this weekend:

Step 1 I began writing this blog and got stuck with what to say.

Step 2 I took a break and remembered that collaging is a great way to get underneath something that is challenging me.

Step 3 I used a white bristol board and wrote the shame and guilt statements on it to remind me what I was looking for.

 

The mind is a smart and manipulative place – it’s easy to forget what you are doing when it’s uncomfortable and painful.

 

Step 4 I looked through old magazines to find images and words that represented the statements I wrote on shame and guilt.

Step 5 I  set a time limit to find images and statements. – I used the length of DJ Drez‘s album 4 AM Plum Mood 

Time boxing any activity gives focus and support to achieving your outcome.

Step 6 I glued images and pictures onto the bristol board. (See main picture of this blog)

Step 7  I identified the patterns and beliefs from the collage and finished writing the blog.

Final thoughts:

At the beginning it was it was hard to find pictures and slogans – most magazines write and include photographs of happy healthy people.  My mind kept saying to me – I don’t have guilt or shame about my diagnosis anymore, which I believe is just my ego not wanting to be vulnerable in admitting my feelings about this.

I was hard pressed to find a story or slogan about guilt or shame.

I came across an advertisement for Abilifly – a mood stabilizer used in the treatment of bipolar disorder and the picture of the person in the ad was looking away vs. into the camera.

 

What I learned about shame and guilt.

  • Having people around me who understand, get it and can say “me too” is really a powerful place to hang out. I’ve been attending a peer support group that is designed for individuals who have been diagnosed with bipolar disorder.  I feel comfortable, I can tell any story about my manic episodes, or how I’m currently feeling and know that everyone in the group has their own version. I urge you to find a peer support group that you too can feel comfortable in.
  • The more I detach myself from “I’m a mistake because I have a mental illness” the clearer I become in my work and ability to communicate. My creativity is unleashed and my effectiveness in creating powerful relationships is unstoppable.
  • To conquer shame you’ll need to transform how you think. It’s a change of state for your mind. Begin looking into ways to transform your thoughts about yourself. The antidote to shame is empathy.
  • Be vulnerable with people you trust. You could start with yourself and write about your feelings of shame.
  • The more I speak publicly about my journey with bipolar disorder, the less shame I have about it.
  • Something Dr. Brown suggests; be grateful. In those moments when life feels amazing do something that shows your gratitude.

o   Write in a grateful journal.

o   At 12:34 pm (1234) speak, tweet, or write what you are grateful for.

o   Tell someone how much you love him or her.

o   At dinner, before you begin to eat, say what you are grateful for.

What do you do to support and manage your feelings of shame and guilt?  

Please comment I’d love to hear from you!

Please note: I reserve the right to delete comments that are offensive or off-topic.

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9 thoughts on “The Shame and Guilt of Mental Illness

  1. Dear Leslie

    Thank you so much for sharing your story. I am so glad that I found your blog. My wife has clinical depression, my three oldest children were diagnosed with bipolar disorder years ago (they are 19, 21, 23 now), and my youngest (17 years) was diagnosed with aspergers syndrome when he was in grade school. I have fought for years to speak out against the stigma of mental illness. I frustrates me that so many people are so narrow minded that they cannot see or understand what the person with the illness is going through. My wife and I have been married for 24 years and I consider myself so blessed to be her husband and blessed to be the father of my four children. I am 53 years old and when the recession put me out of a job four years ago, I decided to go back to school to be a social worker. I have not graduated yet, But look forward to the day when I can spend all day working with people whom society has forgotten and let them know how special they are and how they deserve to be happy. You are a very inspiring person and I am honored to have had the opportunity to read your words.
    Take care and God Bless
    Rick Clarke

    • Rick, Thank you for your message and sharing about your life. I believe that life gives us opportunities and you certainly have found a way to use your gift. Keep in touch. Feel free to connect with me on linkedIn.
      If there is anything I can do, please let me know.
      Leslie

  2. I wish to get across my admiration for your kind-heartedness for persons who need help on this important area. Your personal commitment to getting the message around became exceedingly productive and have in every case empowered ladies much like me to attain their pursuits. This informative publication signifies a whole lot to me and a whole lot more to my peers. Many thanks; from each one of us.

  3. I think the person who has the regrets – the regrets are for actions performed in the past when I didn’t know, REALLY know, what I know now. And Maya Angelou says when you know better, you do better. So I had to have done poorly, because I never learn anything if life is brimming with success. So You only do better today, because you did poorly yesterday, and you take that yesterday person, sit her down, and thank her for teaching you the way to become the strong, beautiful woman you are today. Tell her you are going to stop browbeating and feeling guilt because you can see how hard it was for her in the past. Tell that sweet, brave, resilient young person you know she was in pain, but it’s ok now. You’ve got her back. Give her, and you a hug. Try to get in a meditative frame of mind, breathe deeply, and know you can continue to choose hope over despair. It really works, and your younger self will thank you for it.

    • Helen, sometimes easier said than done. My experience is this self awareness work tends to be link an onion, you think you have handled something, or have a practice in place to management it and all of a sudden it shows up again, different circumstances, but same darn feeling. I agree the medicative state is one that if it can be achieved can be very useful. Thank you for your comments. Please keep in touch.

  4. Leslie, thanks so much for sharing so poignantly about the topic of mental illness, guilt and shame which I believe many people with mental illness struggle with, often silently.

    Insight can be a double edged sword. Without it many people with mental illness never establish the level of wellness they could; however, with insight, I believe most people I know with mental illness struggle with guilt and shame, about having a mental illness, about things they said or did when unwell, about not being able to live up to their roles and responsibilities, even if only temporarily, about the impact of their illness on loved ones and relationships etc…

    “To conquer shame you’ll need to transform how you think. It’s a change of state for your mind. Begin looking into ways to transform your thoughts about yourself. The antidote to shame is empathy”. The CBT coach in me was cheer leading from the sidelines! You are doing your own CBT which to me is the greatest gift a therapist can give their client.

    Your whiteboard exercise is a great example of using the Downward Arrow technique to get to the Core Belief(s) underlying automatic or negative thoughts, “My Mental Ilness =I am a Mistake”. I love your creative, multi stepped plan for chipping away at this Core Belief about yourself. I believe another important strategy you could employ is the one you spoke of when you were working so hard to hide your illness. “I needed the evidence to prove I wasn’t broken. If I could hang on to friends, jobs, contracts and gain trust from the people around me it must prove that I am a worthy human being, not broken like my mind tells me”.

    Playing Prosecutor and Defense, what is the real, factual evidence against “My Mental Illness=I am a Mistake? What specific evidence is there that you ARE NOT a mistake? What worthy characteristics do you have? What worthwhile things have you done in your life? What about you, ILLNESS AND ALL is evidence that you ARE NOT a mistake? What would others tell you if they knew you thought you were a mistake? What evidence against this would they provide? What would you tell someone in your support group who shared this belief about themselves? Do you think they are “mistakes”? What positive things have you learned about yourself, others and the world by having your illness? What values do you have now that you have gained from experiencing this illness?

    What do you want your new “Core Belief” to be? Experiment by trying it out every time you gravitate to your old Core Belief. Do you feel differently when you look at yourself more factually, in a kinder light? While you may make modifications to your new Core Belief as you go, eventually you will develop a healthier Core Belief about yourself.

  5. I notice some things about you immediately just from your writing, without even meeting you. You are an extremely creative person, an articulate, beautiful writer with an ability to express yourself in ways many of us can only wish to do. You have done some deep soul searching that has led you to some insights you don’t like about yourself. This is not a negative! Most of us aren’t brave enough to look inward so frankly, to identify behaviors we don’t like in ourselves and start changing them-let alone blog about them in such a vulnerable way.

    I appreciate your honesty that in trying to keep your world together you had less time to care about others’ hopes and dreams, missing out on deep connections with others. The insight I wish to share with you about this is it is hard not to be narcissistic when one is trying desperately to “survive” a tidal wave! This is really what it is like for many when they develop mania and psychosis. An accidental but perhaps accurate pun to your “Survivor” comment about not wanting to be voted off the island! It takes a lot of energy to always try to be controlling one’s thoughts and behavior which makes it hard to look outward. It’s not really different than being in the dark tunnel of depression with blinders on impacting ones peripheral vision is it?

    When someone first becomes ill it is hard for their life to be anything but illness, it is an inward process. Through the journey of acceptance and recovery, life becomes more than illness and starts to open up again. There was nothing wrong with what you did, it was a survival skill that worked back then just as being passive works for a child when being abused but no longer works in their relationships when they become an adult . Now you are ready to expand outwards again, to develop deeper connections. You don’t have to share with everyone about your illness, you can pick and choose who you trust to share with. My sense is that some deep connections are in your future, if not already there now.

    I also wanted to share that your collage exercise is similar to one I do in a Perinatal CBT Group for Depression and Anxiety I co-facilitate (which does not exclude women with Bipolar Disorder). We have the women go through parenting magazines and pick photos and ads that speak to them. Then we do a group exercise about how mothers develop their definition of Motherhood from the expectations of others, from the media, society, their friends, families and partners. I can’t believe some of the images in those parenting magazines! Children all dressed in white, eating jam on immaculate white furniture; a pregnant woman wearing a ski suit, doing the hula hoop with a child on her hip; a woman dressed in Victoria Secret lingerie with a beautiful red washer and dryer behind her with laundry so neatly stacked it looks ironed, again with a baby in her hip… They often pick black and white photos of dads with naked babies in their hands looking doting at their child.

    Perhaps the reason you couldn’t find images, stories or slogans about shame or guilt is that these don’t fit into the “perfect life” we all are “supposed” to live.
    While I find many people initiate conversation about their guilt and shame associated with their illness or things they said and did when acutely ill, others don’t and still others actively avoid it, claiming not to be ready. If it’s okay I will share your blog with clients, perhaps as an opening to discuss the topic, particularly for those who are trying to hide from acknowledging and delving into it.

    Thanks again for sharing your thoughts.

  6. I’m here in tears. If I were to write about me I would have used your words. I was diagnosed with bipolar in 2005 at the age of 55. For 55 years I was holding on for dear life that people would see the person I wanted to be and at the same time, terrified they would find out the truth. Something was wrong with me. I was so scared. I remember having depression when I was 8 years old. My pediatrician asked my mom to leave the room and asked me if I was OK. I had my chance, but I didn’t want her to know either.

    And the guilt for all the devastation in my wake for all those years…like leaving my husband and 3 year old daughter with a one way ticket and $100 to Vancouver (I lived in Santa Barbara). I don’t remember how I got home, but when I did, I had no marriage and was not a fit mother. My ex married someone who told her that “her mommy didn’t love her” all the time. etc. etc. etc. I called everyone I could reach that I remember hurting and apologized and explained why I did what I did. They were all very forgiving. As I suspected, my daughter also has bipolar. When I knew the symptoms, I knew she had it. I suggested she talk to a psychiatrist and start her recovery in her late 30’s instead of 55 like me. She and I are so close now. I am so grateful. I’m also close to one of the ex-husbands I left one day because there was something better to do. The guilt was sickening.

    I saw Dr. Brene Brown a few times on Youtube, Oprah and the Katie show. I started looking at what was shame and guilt in my recovery that I wasn’t addressing until then.

    After 4 years, we got my medication right and therapy for the last 2 years. I set up an emergency support team of friends and professionals that I gave permission to take over if it was clear I couldn’t manage my life. I only had to use the group once and it worked perfectly. Ginko Biloba in a new supplement I started made my meds ineffective and it was like the floor was pulled out from under me. I’m almost back to 100%, but vigilant…always vigilant and committed to doing what ever it takes to stay stable.

    Learning to let down my guard is still very difficult. After 55 years of protecting myself I’m having a hard time letting go and let others love me because I’m worth it, just the way I am (bipolar, ADHD, anxiety and all) and not because of my façade.

    Thanks so much for writing this blog and sharing with us. I totally get it.