Stigma, Mental health conditions

02 February, 2017

Eating disorders: What lies beneath

When we have a mental health condition like an eating disorder, the idea of admitting that we have struggles is often overwhelming. We look at how we can support someone to be their true selves in difficult times.

We all wear masks in various aspects of our lives to fulfil our daily roles and to meet expectations. For people who experience mental health difficulties,  including anyone with an eating disorder diagnosis, that mask is one that they often struggle to discard.

The added stress of stigma

The added stress of stigma

The idea of being completely honest about who we are, admitting that we have struggles and difficulties, is often overwhelming. We all want to fit in, to belong, and exposing ourselves as somebody who is struggling or less than perfect brings significant turmoil, angst and distress. People may struggle with coming to terms with a diagnosis of mental illness and a journey to recovery which may not be straightforward.

The English dictionary defines stigma as “a strong feeling of disapproval that most people in a society have about something, especially when this is unfair.” Stigma is complicated: individuals stigmatise themselves about their own mental health difficulties, and society’s lack of knowledge and understanding about mental illness can result in stigma for an individual.

The added stresses and difficulties of dealing with both their own self-stigma and the ongoing societal stigma around mental illness and mental health difficulties can sometimes be just as difficult as the illness itself. The mask of pretending we are grand or that everything is okay becomes a tool for survival.

How do we know what lies beneath for any individual, even those that we think we know? We don’t always know or understand what it is to live in someone else’s world or walk in their shoes. We look at people, even those that we are close to and sometimes take them at face value: what we see, how they look. We often fail to recognise what is going on behind the outer mask. It is often only when someone opens up to us that we look back and see what we missed or feel guilty about what we should have seen. When someone needs to hide behind a mask, they can do so very effectively, and it is only with experience, patience and knowledge that we can uncover what lies beneath.

Behind the mask

Behind the mask

Being able to talk about our own mental health difficulties takes great courage: it requires an acceptance of oneself and an unburdening of the self-stigma so many who experience mental health difficulties carry with them. It means discarding a mask and a way of being that has become so ingrained that it can seem impossible to remove. It means reaching a stage in one’s recovery where one has come to understand themselves and is able to verbalise what lies beneath the other mask that the rest of the world sees. It means feeling supported and accepted by those to whom a disclosure is made.

As a society, we need to understand the prevalence of mental health difficulties and that what we see is not always a true reflection of the inner turmoil and distress that someone is experiencing. As individuals, we need to understand that nobody is exempt from experiencing mental health difficulties and, even though somebody may look fine, it should not be an automatic assumption that they are.

We need to learn to be kinder and more accepting of each other, to look beyond the outer mask and to allow people who experience mental health difficulties to feel able to talk openly and honestly. We need to encourage open dialogue on good mental health and emotional wellbeing so that we can live in a society where our mental health becomes part of who we are, not something to be hidden behind an outer mask of perfection.

We need to look beyond the mask and find out what lies beneath, to support people in discarding their self-stigma and becoming their true selves.

This blog was written by Mary O'Hora, Manager of the Information Centre at St Patrick's Mental Health Services.