Destigmatisation: What does it look like?
- Kasandra Ferguson
- Jun 18
- 5 min read
Updated: Jun 19
In the modern day, everyone has heard about the push to “destigmatise mental illness” – a perfectly noble goal. Nonetheless, I find that when many people are pressed to explain what this truly means, little explanation is offered beyond being understanding.
But what does that look like, truly? What about the things that aren’t easily understood, that can’t be solved merely by offering someone space or a “mental health day”? Why do many oft-repeated phrases about destigmatisation often sound like vague platitudes, offering me only the briefest reprieve from the social and professional consequences of an illness that has otherwise caused huge disruptions in my life? With mental health stigma potentially back on the rise, I can’t help feeling that this push for acceptance was only partially earnest in the first place.
I sometimes wonder when people express how “we all get depressed now and then”, what they would do if they knew that I’ve had delusions. That mania can encourage me to run up all my credit cards, make dangerous sexual choices, and fill me with an energy so bright and all-consuming that I won’t eat for an entire day and not feel any different. That depression can leave me in bed for hours and hours, staring at the wall without distraction or preoccupation, or urge me to crack my head against the wall simply to stimulate some sensation in my body.
But it’s more than this. Despite my best efforts, my symptoms cannot be totally self-contained, and this appears to be a major hurdle in the quest to destigmatise. If I miss my meds, I grow hypersensitive, snippy, and reactive. I get rejection sensitivity so intense that I feel actual shooting pains in my limbs, and it’s hard not to unfairly take this out on others. I make impulse decisions that remove others’ agency or step on people’s toes in the workplace. I lose touch with people and cut others out of my life unfairly. At many points, I have objectified people and used them only to see how much serotonin I can squeeze from their attention, like wringing out a rag, then wondered why none of my romantic endeavours succeeded.
I work on these things often. Now engaged to a neurodivergent man, my partner and I, as a rule, explain our behaviours – not to excuse them, but to help the other understand that these actions aren’t their fault. His overstimulation and subsequent hypersensitivity need accommodation, not my hurt feelings, and my impulsivity and back-and-forth moods need communication, not condescension.
This delicate balance acts as a barrier for many people, despite their good intentions to understand the vast and varied experiences of people with mental illness. I have often felt that my experiences as a woman with bipolar disorder are judged on several levels. My disorder takes up space in my life and interjects itself into my relationships with others. Instead of a wilting flower whose limitations inspire sympathy, I am a loud, “difficult” woman. I have often noticed that when a man falls victim to loneliness, depression, emotional distance, alcoholism or other dependencies, they are sometimes offered sympathy, the cluck of a tongue, and a comment about their struggles; women do not seem to have this wiggle room to be messy. The limitations of gender feel doubly suffocating when intersecting with those of wellness.
Many others living with mental illness or neurodivergent people I know have experienced this. An autistic man who is paralysed by his inability to focus or socialise is called lazy or flaky. Meanwhile, his disinterest in social constructs of masculinity, which can be even more illogical to someone not naturally attuned to social cues and structures, inspires homophobic comments. A woman with Borderline Personality Disorder (BPD) is perpetually perceived as flippant, a loaded gun, while a man with depression so severe that he struggles to maintain physical hygiene or steady work is a layabout. An autistic woman with a black-and-white view on sexuality is slut-shamed or misdiagnosed.
(Many autistic women are misdiagnosed as having personality, anxiety, or mood disorders. After all, autistic people couldn’t possibly partake in romance or sex like allistic people, could they?)
It’s hard to encourage neurotypical people to be more conscious of these possibilities and symptoms without sounding like I’m making excuses. Normalising or destigmatising something doesn’t necessarily mean those things are positive or should be accepted uncritically. It’s just removing the shame surrounding them or shifting perspectives. However, making changes takes time, thought, and a series of improvements in one’s environment, and some changes will even require relocating, therapy, and new items or equipment, which all cost money.
So, what do we do? How can I reliably tell someone that I got exceptionally manic and irresponsibly took over a task on a group project, potentially damaging the quality of our work in the process, because I was in a new house, lost my support system, and went off my meds? (Something that actually happened.) Moreover, how can I do so without fear of losing a friendship or the respect of a coworker? The truth is: I can’t. The fear will be there, inspired mostly by the fact that I can’t control whether a person wants to keep my occasional unreliability in their life or workplace. It’s worth trying, though, because there are people in my life who surprise me.
But it’s not one-way. Suppose someone is truly interested in accommodating mentally ill and neurodivergent people. In that case, they will have to make peace with the fact that they can’t always understand others’ actions or feelings. Not all mental health symptoms or episodes are common or “reasonable” or “sympathetic”. They might not have distinguishable causes – or if they do, you simply might not know about them, nor are you necessarily entitled to.
But imagine navigating a world where every job you need to survive, every social interaction you participate in to feel connected to others, feels as if it’s not made for you. People shift at comments that you believed were normal – maybe even ones you practised – and suddenly pull back from socialising with you, and you can’t understand why. Jobs are again increasingly unwilling to accommodate hybrid schedules or remote work; attending daily is either physically or psychologically overwhelming, making you more likely to quit the job and plunge yourself into financial instability. In some cases, as in mine, you’re told that treatment through medication, therapy, or (ideally) both will be not only beneficial but necessary to successfully manage your disorder; otherwise, the illness is degenerative and likely to exponentially impact your life. It’s exhausting.
A more open mindset won’t solve everything. A genuinely understanding person can offer a disabled individual relief, assistance, and accommodation, but, as is the case for physically disabled people, changes must be structural as well. Until someone can ask for sensory-safe spaces, can mark that they have a disability on a job application, can mention the less common side effects of their mental illness without fear of being denied a job, housing, healthcare, friendship – until these changes are institutional as opposed to simply individual, stigma will still linger. Still, social movements begin internally, and they then enter the political discourse, where wider change can be made.
This article has been sponsored by the Psychiatry Research Trust, who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.
