What is Shame?

When it comes to mental health problems and mental illness, shame can be feelings of guilt, embarrassment and distress.

There are two different types of shame: internal and external. Internal shame is related to views that a person may have about their own behaviours or attributes, in this case, around their mental illness. Whereas external shame is when a person may believe that their illness would lead to a negative response if they were made public.

Shame is closely linked to self-stigma, and has been referred to as the ‘emotional consequence of the stigma of mental illness’. Feelings of shame lead to people with mental illness anticipating experiencing stigma, so withdrawing from situations, as they can be made to feel that they are ‘less than’, or that they are ‘unworthy’.

It can also impact different groups in different ways.

Within minoritized groups in Scotland, shame has been found to be the “most common response to mental health problems.” Cultural values and beliefs, including those relating to the causes of mental illness), can cause or exacerbate feelings of shame within minoritized groups in Scotland (Knifton, 2012).

Men report having lower levels of knowledge about mental health, are more likely to feel shame related to mental health than women, have more negative attitudes towards seeking help for mental health issues, and are consequently less likely to seek help.

“I have felt shame around my mental health, yes. I think there’s this image of eating disorders as a white, privileged female illness, when it’s a mental illness that anyone can experience, at any weight.

"Most people don’t understand that, and that men can suffer eating disorders too. Certainly, in my time, it’s been called ‘the slimmer’s disease’, and people haven’t believed men could have an eating disorder.

"They usually blamed, or put it down to being attention seeking. So, I’ve certainly felt shame around that.

“One thing I would say caused shame was with the first person I had as a psychiatrist. She said I had Munchausen by Proxy, just because I was a man with an eating disorder. She didn’t believe it at all. She actually said, ‘I think you have Munchausen by Proxy, because if you do have an eating disorder, you are an enigma’.

"She also said I was doing it to get attention from my dad. Because I lost my mum, and my dad lost his wife, I wanted attention off him. ‘I think that’s what it’s all about’, she said. And that caused some self-stigma because, at the time, I didn’t know what an eating disorder was. And, for a professional to say that to me – that it was all my fault – I began to think, well, these are the people you trust and go to for help… if they’re saying that, it must be true.

"So, I kind of withdrew further into my illness and it prevented me from accepting I had an eating disorder and accepting the help I really needed. It took me getting another psychiatrist, further down the line, to reach some kind of turning point and move forward with my recovery. They diagnosed me with anorexia and bulimia, and that gave me access to the help I needed.”

We asked people with experience of mental illness across the UK, where do they think that it doesn’t feel like it okay to not be okay. Have a read here, and if you’re feeling alone, perhaps you will see that other people out there are feeling the same way. Here is what they said.

If it’s okay to not be okay:

• Why do I say I'm fine when I'm not?
• Why do I hide my story?
• Why cover up my feelings?
• Why do I avoid close relationships?
• Why am I terrified of letting people down?
• Why do I feel ashamed of my mental health struggles at work?
• Why was I made to feel ashamed that my brain is wired differently?
• Why was I made redundant after 30 years spotless service in the public sector?
• Why do people no longer return my calls?
• Why am I told to "think of the positives".
• Why do I always say “fine thanks” when people ask how I am?
• Why do I keep taking too much on when I am already practically burnt out?
• Why won’t I tell anyone about my distressing intrusive thoughts?
• Why I do I feel bad, for feeling bad?
  Why am I still hiding it?
• Why is it easier to call in sick than request a mental health day when inside I'm breaking?
• Why am I so ashamed I'm barely coping myself?
• Why can't I admit I need help?
• Why can't I stop judging myself?
• Why does my dad still tell me to ‘catch yourself on’ when I talk about my mental health?
• Why am I so ashamed of my mental health that I don’t step outside front door?
• Why are my family still embarrassed by me
• Then why am I treated differently?
• Why am I persecuted?
• Why do medical staff still not understand me?
• Why do you still not have time for me?
• Why do you still under-invest in my health?
• Why do my family still feel they need to over-protect me?
• Why are we not talking about childhood trauma?
• Why do you still not feel my pain?
• Why do you treat me differently?
• Why do people judge me and treat me differently once they know about my mental illness?
• Why do I feel bad in saying NO?
• Why do I blame myself for feeling like I do?
• Why did I not include this on my CV many years ago?
• Why am I worried that my mental health diagnosis and potential problems will affect my career prospects?
• Then we need to feel able to say so, without feeling guilty’
• Then we need to acknowledge that, because until we do, we’re stigmatising ourselves’
• Why am I ashamed to seek help?
• Then why when I show actual symptoms of my mental illness, do you act like it's not ok?
• Why were managers at my last job allowed to make humiliating and cruel comments about me, before sacking me?
• Why do I worry that getting a diagnosis for anxiety will prevent me from getting a job I love?
• Then why is the government forcing people to go to work
• Why can’t I talk to my work colleagues about my anxiety disorder