Overcoming the Stigma of Schizophrenia
To family and friends who are recovering from schizophrenia:
One of the long-term obstacles to recovery is self-stigma. Once symptoms of schizophrenia become manageable or even eliminated, lingering issues related to self-esteem and negative self-image can continue to impact your potential for personal growth. I have seen this in my own son and in clients who think that “this is the best I can do” and settle for less than they are capable of doing or being.
Self-stigma is the unrealistic belief that you are unable to to accomplish a goal, whether personal or professional, even in the face of contradictory evidence. Individuals who have faced long-term physical or mental illness may be especially susceptible. For one, having reached a comfortable level of recovery, they may feel a relief that life looks so much better now that symptoms are manageable. “Why would I want to upset the balance that I have achieved? This feels pretty good so I will enjoy this and stay where I am.” This perspective is certainly understandable and once someone has reached a place of recovery, they deserve to enjoy it. Recovery is hard work. Enjoying the fruits of hard work is important.
Also many recovered individuals have experienced major or minor relapses when stress becomes overwhelming. Wanting to maintain a status quo seems safer than risking possible setbacks. Starting a new job or a new relationship/friendship can be stressful. New experiences are stressful for most people but especially for those with serious mental illness. When there is a fear that unwanted voices may return or other symptoms may surface, change can be even more complicated and fearful.
In addition, schizophrenia has been associated with misunderstanding and misplaced fears. Even today many people are afraid to be around someone with mental illness because they are afraid of potential violence. Fears continue to increase and many assume that mass murderers have serious mental illness with psychotic features despite research findings that most individuals with serious mental illness are more likely to be victims of violence, not perpetrators. These external stigmas from misunderstandings often become part of a diagnosed individual's identity even if you know the real facts about you illness.
In addition to the violence fears, another stigma that often gets in the way of treatment is the belief that schizophrenia is not treatable or that the diagnosed individual will never be able to meet treatment standards or live an independent, productive life. While it is true that recovery can be challenging and may take individuals months or years to attain the level that they want to reach, most psychologists and psychiatrists are aware of the recovery statistics and now accept the Recovery Model. Finding mental health professionals who believe in recovery is an important part of coping with recovery stigma.
What about personal self-doubts, however? Challenging your personal belief system and recognizing the strengths that you have gained along the recovery journey is important. If your image of schizophrenia is tainted by negative, stereotypical images, spend some time learning about those who have recovered and what has helped them. There are websites with information and interviews of people who are coping with their symptoms or who have recovered usually with the help of continued medication and therapeutic support. ( https://schizophreniaoralhistories.com/ or https://curesz.org/survivors/) Learn about the facts of your illness to counteract myths and misunderstandings. (https://sczaction.org/ , https://www.nami.org/ and https://www.treatmentadvocacycenter.org/). And remember that you are not your illness. You are not a “ schizophrenic” but you are a person with schizophrenia. A person with diabetes is not a “diabetic” but a person who happens to have diabetes. Some illness need lifelong treatment but that illness and treatment does not have to define you as a person.
The fear that excessive stress may trigger a return of symptoms also needs to be considered and addressed. One of the valuable tools that you can learn from psychological counseling is stress management. Explore the wide range of stress coping strategies to find methods that work best for you. You may find some interventions work best with low levels of stress while other behaviors are needed for more demanding situations. You need a “tool kit” of possibilities.
In addition, maintaining a realistic, healthy perspective is important. If you are at a point in your recovery where you are feeling comfortable but wish you might do more, you might be ready for more. This is the time to give yourself some recognition. Give yourself credit for all that you have accomplished. If you have been able to get this far, perhaps you could do more if that is your wish. If your supervisor suggests a promotion that might seem too stressful, it might be useful to assess the level of stress involved in the job description. Most likely your present job was stressful to begin with but you figured it out. Might it be possible that you would figure this out too? Or starting a new friendship or relationship can provoke anxiety for many people. Learning how to take new experiences in small steps, remembering how you may have been successful in the past, and using stress coping skills may help you to enrich your life and find new possiblities.
Managing or eliminating symptoms of schizophrenia is a huge accomplishment. If you are still wanting more, acknowledge your progress. Identify your personal strengths and abilities and utilize resources from your treatment team to expand your stress management “tool kit.” Finding support from within yourself and from your support team may give you the boost that you need. The valuable part of your recovery at any stage is not to hinder your growth by stigmatizing yourself.