text: Stigma refers to the negative attitudes and beliefs that motivate people to fear, reject, avoid, and discriminate against people with mental health conditions. Stigmatisation of mental health conditions remains extremely widespread and is experienced by many people with mental health problems. People we talked with felt that regardless of numerous public awareness campaigns in Australia in recent years, stigma related to depression and other mental health conditions is still commonly experienced. Stigma can lead people to avoid living, socialising, working with or employing people with mental health conditions – especially those towards the more severe end of the spectrum.
  Many people talked about the impact of stigma on their lives and how it contributed to their sense of low self-esteem, isolation and feelings of hopelessness. Responding to stigma, people with mental health conditions tend to internalise public attitudes. They often felt embarrassed to discuss their symptoms and sometimes avoided seeking treatment. People told us about hiding their depression from their employers and being ‘genuinely afraid of other people knowing’. They were concerned of being diminished in the eyes of others, being seen as professionally incompetent, and losing out on career advancement opportunities.
  Some people decided not to discuss their mental health. They were hurt when those who knew about it did not consider it a serious health problem. A few professional men in high-status professional roles decided not to disclose it because they were concerned about being ‘ridiculed or pitied or pastored’. Some were reluctant to discuss it at all while others chose carefully whom they told. Most people decided to share their condition only with selected family members, partners or a few trusted friends, without disclosing it to others in their social circle.
  By contrast, some people found it helpful to talk openly about their depression. They believed that being open contributed to destigmatisation of depression and helped others with similar problems to acknowledge this and seek appropriate help. A few people perceived a positive change in social attitudes to mental health and increased awareness of depression. However, stigma associated with depression persisted, including with the word ‘depression’. Some suggested that renaming depression or normalising emotional distress, which is frequently experienced by new mothers for example, might help in destigmatising the condition.
  A few people talked about the importance of attitudes towards depression at their workplace. Colleagues’ reactions were a major factor shaping whether or not people felt stigmatised. Some people experienced positive and supportive attitudes, while others felt judged.
  A few people compared their experiences with reactions to physical illness and to depression. There was a general view that people were more sympathetic to physical illness than to depression. Comodor commented that physical illness was obvious, but ‘depression’s different, that’s mental. I don’t think that’s something you spread around’.
  Debra linked perceived stigma in relation to depression to her decision to marry her ex-partner, as well as her sense of being seen as a failed mother. Speaking about her ex-husband, she explained that: ‘because I’d gone through the panic attack stages with him, I felt that nobody else would ever ask me to marry them again as a person with a mental illness’. After they divorced, Debra’s distress became more severe and she had to give up custody of her children and let them live with their father. Despite this being in her children’s best interest and despite her staying in contact with them and supporting them financially, Debra felt that social norms associated with motherhood meant she was seen as a failure by some members of her social circle.
  A few immigrant women we talked to from African and Asian countries observed that there was no word for ‘depression’ in their first languages. They explained that depression was not a commonly acknowledged mental health condition in their countries of origin, however, there was a clear understanding of severe mental health conditions and these were highly stigmatised. Akello who is from an African background and who was treated for depression in Australia talked about hiding the fact that she was taking antidepressants. She said she had felt stigmatised by some members of her community after she revealed this information. A few other people also told us about concealing taking medication, as they felt ‘there was a great stigma in taking antidepressants’. Safra spoke about social norms of sharing with others only one’s successes in life, and not talking about problems, including mental health conditions.
  In general people were concerned about stigma attached to mental health conditions in Australia. They took great care in choosing whom to disclose their depression to and often tried to hide it from colleagues and particularly superiors in the workplace. They would usually talk to their family members and close friends first, these being the people who would notice behaviour changes and be affected by these changes. However, a few commented that they had noticed some increase in public awareness of depression and expressed hope that this would further reduce stigma related to depression and other mental health conditions.