Kiele Twarowski spent years thinking it was shameful to take medication to treat mental illness. So when she started having trouble with her mental health, Kiele found she had already internalized the societal shame associated with taking medication. “I thought it was something to be quiet about and not share, so I didn’t want to take them,” she says. Eventually, though, her mental health became challenging enough that she explored meds with the help of a professional, and now says she’s “thankful” she did.
“For the longest time I was really afraid to take medication that would ultimately end up changing and saving my life,” she says.
This experience is not totally uncommon. In fact, pill shaming is a regular occurrence, and I've experienced it: I let stigma prevent me from exploring the pill option for years; a number of people in my life expressed skepticism or concern about the impact of my taking mental health medication, and I stalled. But those kinds of apprehensions aren't fact-based, and keep people like Kiele and me from taking necessary medication that could drastically improve our lives.
Where does the stigma come from?
According to Carlene MacMillan, M.D., a psychiatrist in Brooklyn, “Pill shaming is the natural consequence of what happens when a society stigmatizes mental illness, as it is one of the most obvious and consistent external reminders that a person has a mental illness.” In this way, taking medication can be a daily reminder that something is “wrong” mentally, she says.
Kim Meehan, a psychiatric nurse practitioner, says a lack of education also contributes to stigma.
“What I hear most from my clients includes starting medication is the 'last resort,'" she says, "and they're only doing so because they 'felt like it meant they failed,' that they were told constantly to just 'suck it up' or were invalidated that their feelings were not real, and that 'taking a medication is just a Band-Aid, but does not treat the cause.'”
Psychotherapist Patrice N. Douglas believes that the stigma causes an increase in the number of people who don’t get their mental illness properly treated. “As long as we shame people for taking medications for their emotional well-being, we are creating avenues for people to treat their issues in silence by buying their medications on the street which is highly dangerous,” and can also lead to self-medicating with unregulated substances, Douglas says.
Beyond these factors, though, is an underlying cause that may contribute to many of the things our society thinks of as taboo or bad: fear of the unknown. Juli Fraga Psy.D, a licensed psychologist, says, “Pill shaming can also stem from people's projections and fears about their own mental health, and criticizing someone is one way to defend against one's own emotional struggles.”
With all that in mind, how do we stop pill shaming from happening?
Meehan believes education is key. “The majority of the public gets information about mental health from drug commercials," she says, "which is why there are so many misconceptions about medication.” Many of her clients, she adds, have expressed worry that others will judge them for taking medication, but a practitioner tries to reassure them that it’s no different than getting treatment for a physical condition, while educating them on how medications can help reduce the intensity of their anxiety and depression, and make lifestyle changes more attainable.
Communication is also important to stop pill shaming. “The most common question I get from my clients is, 'Is this normal?' or 'Do other people feel like this?'” Meehan says. "When anxiety disorder is estimated to impact 31% of the U.S. population during their lifetimes, the chances that someone in your life has experienced something similar to you are very likely. Although we are taught to not discuss these challenges publicly. The more we talk about it, the more we learn that we are not alone in feeling this way, and can get support from others.”
Furthermore, psychotherapist Jennifer Musselman believes the language we use to describe mental and emotional wellness is steeped in stigma, which perpetuates it. “The phrase ‘mental illness’ already creates a negative and shaming connotation,” she says. If more people share their experiences with mental health, it will allow us to see these terms in a new, more realistic light; Musselman is working to reframe it as “mental wellness.”
“If we recognize symptoms in ourselves or our colleagues and friends, we can support one another and destigmatize seeking support for mental wellness,” she says.
On an individual level, we need to teach people that it’s OK to be open with each other — accordingly, social media could really help move the needle. “I am seeing more and more [discussion] on Instagram,” says Dr. MacMillan. With a multitude of related social media accounts, including @sadgirlsclub, we’re seeing more people get frank about their emotional and mental health online, which is ultimately helping to shatter the stigma beyond our screens.
Next time someone tells you they take medication for mental illness or are interested in exploring it, Dr. Fraga says, “Don't judge and offer your opinion. Instead, offer compassion and offer to listen to your friend or loved one's experience.” We must do our part to unlearn the shame we’ve subconsciously learned.
