Stigma1

My partner was diagnosed with Bipolar disorder and I am not sure how to tell the kids, how to tell extended family members and friends. I don’t want too many people to know as it is a private manner but people are starting to ask a lot of questions. What do I do?

You are not alone in wanting to keep quiet about what your partner is going through. Although there is no right answer as to who and how much you should tell others, there are some things that you should keep in mind.

I. What is your motivation for keeping quiet?

i. Protect person with the mental illness. The person often decides to keep their illness a secret to avoid stigma but with this often comes an avoidance of treatment. One study found that about half the adults reporting believed that looking for help would put them at the risk of being stigmatized (Corrigan & Matthews, 2003). Almost half said they would be embarrassed to see a professional (Barney, Griffiths, Jorm, Christensen, 2006).

ii. Protect the family. Many families keep quiet because of the shame that often comes with mental illness. Shame is connected to the belief that others will blame the family member(s) for the person’s mental illness. There is the fear that people will blame parents for bad parenting skills, that all family members (spouses, siblings, grown children, parents etc.) will be blamed for not helping the person manage their lives or follow treatment. This could lead to being socially disconnected from others as we no longer reach out (Corrigan, Watson, Miller, 2006).

“There are two girlfriends who know about it. One couple... knows about it. He has been to see a psychiatrist and I know they would understand. There’s another girlfriend...and she knows about it. But I’ve cut off all our other friends. I didn’t tell them that I was giving up the apartment and I had the phone disconnected without telling anyone so they don’t know how to get in touch with me (Yarrow et al., 1955, p.36)”.

In more recent research it is still seen that many people conceal their illness or conceal the illness of a family member. In a recent study it was found that half of the relatives concealed their family members’ illness (Phelan, Brome, Link, 1998). The good news is that of the half who did tell others, most found no avoidance by others.

iii. Fear of rejection. Silence can be a coping strategy for both the person with the illness and the family- when they anticipate rejection from others they may withdraw first (Perlick et. al., 2001).Social interaction may then become limited to other individuals who are stigmatized and close family. These coping strategies which reduce social connections may ultimately further set back social adaptation and delay or restrict recovery.

iv. Control over emotions and avoidance of conflict. Do you feel like you need to stay strong and manage your emotions because your family member and the rest of your family need you? This is a very common feeling. Many people spend so much time controlling their own emotions that they never truly confront them. Managing emotions means that many things are never discussed. Pre-empting conflict may result in the situation never being dealt with or dealt with too late (Hinshaw, 2002).

v. Protecting children. It of course does complicate the picture when there are children in the picture and it is their mother or father who has the illness. How do you find the balance between exposure to “chaos” and utter silence? A middle ground needs to be found. There can be a huge effect of silence on children in the long run. They may feel abandoned, left out, confused (Hinshaw, 2002).

A supportive network around someone with a mental illness has been shown to be one of the best ways to reduce relapse (Ostman, Kjellin, 2002). By keeping silent, the result will be pushing others away and reducing the social support that could be there for your loved one, you and your family.

Even in you struggle reaching out to those you currently know, there are others out there who are going through the same thing and could relate. Many families have reported that interacting with other families who have a relative with a mental illness is helpful in overcoming stigma (Wahl & Harman, 1989).

Back to Stigma and Social Control