Stigma. It’s defined as “a mark of disgrace.”

In the recent survey I conducted on the likelihood of people admitting depression and/or seeking treatment, what did 43.8 percent of women state as the Number 1 reason for not telling someone they were depressed?

“Others would think I am weak or think less of me.“ Aka stigma.

For men, the Number 1 reason. “I believe I will get over it by myself” (57 percent), followed by the same reason as women, the fear of being seen as weak, at 32 percent.

Men seem to believe that depression is like a flat tire. You can fix it yourself. No problem.

So, what will other people think of us, if we admit a mental or emotional problem that we can’t fix, or isn’t easily resolved? The doubt and insecurity about how we appear to others is causing people to hide what they’re going through. And suicide rates are increasing rapidly.

I have written a lot on what I term Perfectly Hidden Depression (PHD).

People with PHD either intentionally conceal their struggle, or their facade of everything being perfect has become so much of who they are, they don’t even think about it anymore.

The label of “mental illness?” Horrifying.

I am currently interviewing people with PHD who have contacted me. The first question I ask each of them is, “What made you reach out to me?“

“Because I had never seen anyone talk about the fact that I’m doing my best to hide the way I really feel. I’ve even had therapists tell me I didn’t fit criteria for depression. And I sit there, knowing they’re wrong. I almost take pride in the fact that I can hide it so well.”

They deny their sadness. They can’t reveal experiences or choices they feel shame about. Somehow, they fear that if they do, the admission will overshadow or overtake the rest of their being.

They hate the idea of showing vulnerability.

Because isn’t depression something that people who aren’t quite right go through? They’re not strong. Resilient. They can’t take it, like other people can. Right?

Wrong.

Fearing the stigma is one of the primary things that makes you hide.

Let’s talk about that.

One of the huge gifts (and responsibilities) of being a therapist is being honored by people who are coming to you for help. Trusting you when they are going through something that makes them vulnerable. I meet people all the time who are depressed — whose minds are fighting off distortions, whose hearts are heavy with despair. guilt, shame, or emptiness, whose lives have been touched by some kind of trauma or loss that has overwhelmed them.

These are not weak people. Far from it. It takes a lot of courage to confront depression.

The work is hard. Sometimes it feels like you’re losing the fight with your mind.

When you have Perfectly Hidden Depression, you’ve detached a great deal from any painful feelings. You keep them secreted away. Thus part of the work — a huge part — is getting back in touch with what you’ve distanced yourself from emotionally. You have to feel.

You have to decide that your entrenched sadness is not weakness. And allow it in.

However you’ve bought into the “stigma” or shame about feeling deep emotional pain has to be confronted. However you fear not looking like you’re in perfect control needs to be understood and accepted. However carefully you have constructed the image of the perfect life — the burden of that facade needs to be admitted.

I love this quote from blogger and author Jenny Lawson on how the stigma of mental illness affects those with depression.

“When you come out of the grips of a depression there is an incredible relief, but not one you feel allowed to celebrate. Instead, the feeling of victory is replaced with anxiety that it will happen again, and with shame and vulnerability when you see how your illness affected your family, your work, everything left untouched while you struggled to survive. We come back to life thinner, paler, weaker … but as survivors. Survivors who don’t get pats on the back from coworkers who congratulate them on making it. Survivors who wake to more work than before because their friends and family are exhausted from helping them fight a battle they may not even understand. I hope to one day see a sea of people all wearing silver ribbons as a sign that they understand the secret battle, and as a celebration of the victories made each day as we individually pull ourselves up out of our foxholes to see our scars heal, and to remember what the sun looks like.”
― Jenny Lawson, Furiously Happy: A Funny Book About Horrible Things

Add to this picture, that in PHD, no one may have even known the fight was going on. No one was trying to help, or cheering, or even aware. You may be fighting the battle with your own depression, while still trying to maintain your perfectionistic and overachieving lifestyle.

Eventually, you may realize that that isn’t possible.

I respect how hard the battle is.

And I will challenge someone with Perfectly Hidden Depression to decide that he or she is worth fighting for — that there is no stigma in healing what is broken.

There is no stigma in not being perfect, or looking perfect.

There is no stigma in self-acceptance.

If you wonder if you experience Perfectly Hidden Depression, here’s a questionnaire for you to take. Just click here. If you believe you’re depressed, please seek treatment.