Sometimes I feel strange and different from healthy people. Perhaps we internalize stigma because we feel a deep sense of shame. We’re offbeat, eccentric, weird and ashamed. Shame makes me want to hide the real me. I don’t want others to see the real me, the one who is embarrassed to be thought of as mentally ill. I don’t want HealthyPlace readers to know it either because I’m afraid they might stigmatize me the other way, perhaps get angry with me because I still sometimes succumb to the disconcerting voice of stigma.

Have you ever noticed that control is a major life issue for people? And have you noticed that we all, as human beings, want to have control of ourselves, others, and pretty much the entire universe, if we had our way? Of course, you've noticed, because you've lived around other people enough to know that our quest to control permeates much of our lives.

One of the worst things about having a mental disorder is the symptoms the mental disorder causes. These symptoms are the cause of much suffering for those of us who have received a mental health diagnosis. We face our symptoms every day, sometimes every minute of the day. They can cause us to see the world and the circumstances of life very differently than people who aren’t mentally ill. Because we sometimes perceive things this way, we occasionally come into conflict with people. It’s often family who don’t comprehend our behavior, especially since they see us at our worst. Misconceptions can, and do, happen, frequently, on both sides. Of course, it’s not only we who misperceive. Misperceptions can lead to stereotyping, part of mental health stigma. Let’s look at some examples of these stereotypes.

Last week brought me a lesson in the need to be prepared when mental health triggers come, as they inevitably do in our recovery. These triggers can be dangerous because they can instantly transport us to a place of emotional turmoil and intensify our symptoms. In order to manage our illness, we must be prepared at all times. We never know when we can be triggered and we need to take steps to ensure we and others around us are safe. This past week, there was a national firestorm with the release of American POW Bowe Bergdahl from captivity in Afghanistan. I had not known the story prior to this, but when I heard the circumstances of his experience, I was triggered in a way that hasn’t happened in a long time.

Mental health recovery is an exercise in hope. Hope—the earnest expectation of coming good. Hope is indispensable to our recovery. Hope can help us move away from the terror of defeat and despondency. It's not an abstract idea that makes no real difference in our recovery. It’s the cornerstone upon which the entire recovery foundation is built. There can be no recovery without hope. Despair on the other hand, is a hellish pit we can find ourselves in if we are not careful.

I have heard a phrase repeated by some in the mental health community. “We just want to be treated like everyone else.” Really? I don’t. Why? Because I certainly am not like everyone else and if you apply their standards to me I lose. Another thing I’ve heard. People with mental illness should be held accountable for their actions just like everyone else—there it is again, “just like everyone else.” I understand the sentiment. It may be what they’re saying is “we don’t want to be discriminated against. Treat us like everyone else.”

The source of much of our discomfort lies in what we find unacceptable. I’m heartbroken because I don’t want to accept that person I loved is gone forever. I’m anxious because I don’t want to accept that I might actually be safe, that no one is trying to purposely hurt me. I’m sad because I have difficulty accepting that there are actually good and lovely things in this world, as well as the bad things. I don’t want to accept that I need to be on this medication now, and maybe for life. All these things, and many more, I find unacceptable.

When should the symptom-induced guilt and shame end and responsibility in mental illness begin? Chris T. (actual person, name changed) has been diagnosed with bipolar disorder. One of the ways his bipolar manifests is hypersexuality. This symptom drives Chris to act out sexually. He's a married man and over the years has had two extramarital relationships. He has come perilously close on more than one occasion to losing his entire family. Chris feels guilt and shame. He doesn't deny responsibility in his mental illness, but his wife is torn apart because of his actions.

I want to tell you about my neighbors. That is, I would tell you about my neighbors if I knew any of them. Now partly, it's a societal change. Many people just aren't neighbors anymore in the classic sense of the word. Oh sure, we'll wave across the fence, but that's pretty much it. I've lived in the same house for 14 years now. The reason I don't do the neighbor thing is because I don't want them to know me.

One of the casualties of mental illness is often any kind of healthy social interaction. If we aren't careful, we can end up in a vortex of loneliness that serves only to make us feel worse about our mental health and cause our condition to deteriorate. Why do we, as people with mental illness, isolate ourselves?