Understanding Stigma in Mental Health and Addiction

Gillian May

Photo by Ben White on Unsplash

Did you know that 1 in 7 people worldwide has been diagnosed with one or more mental health or substance abuse disorders?

That means that every time you walk into a store, an elevator, or mingle in a group, you will encounter many people struggling with mental health and addiction issues. And because these are invisible issues, you won’t know it by looking at them.

Is that surprising? Not really. Most of us know that mental illness and addictions are a global problem that’s likely to get worse in 2020 and beyond.

The facts are indisputable. By March of 2020, online alcohol sales rose 243% in the US, mental health crisis calls were up 891%, and drug-related deaths have increased by 13%. The pandemic made mental health and addictions worse, but the numbers were already concerning before this crisis hit.

Here’s the thing — why, in a world where so many are struggling with mental health and addictions, do we still have stigma? I’m talking about people becoming judgmental, insensitive, and snappy whenever someone talks about their mental health or addiction problem.

When you have 1 in 7 people struggling with mental health and addictions, then we can safely conclude that each of us knows a few, if not many, people with these disorders. I know I do. You’re reading an article by someone with those issues now.

I’m a recovering alcoholic and have struggled with anxiety and depression my whole life. I also have many family members who have various disorders, and I think most of my good friends struggle with current or past issues. As a former mental health nurse, I have a unique personal and professional perspective. Yes, even professionals struggle with mental health and addictions.

There are many reasons why stigma is still an issue, but there’s one reason we rarely talk about — we get triggered by each other. And triggers often manifest into the ugly things we say and do to each other as a reaction to the ways that others remind us of our pain.

And I’m not talking about how we still don’t believe these issues are bonafide health problems that require treatment. I’m talking about how one person’s manifestation of mental health and addictions emotionally triggers another person.

Let me give you an example. Person A has OCD, which manifests as a need to clean and wipe everything down several times a day. Person B, who is good friends with Person A, has depression that manifests as a lack of motivation, fatigue, and an inability to keep up with household chores. It’s likely these people have trauma that relates to these symptoms.

Can you imagine how challenging it would be for these people when one person can’t get motivated to do chores while the other person needs to clean to feel better?

Of course, not everyone is challenged by others symptoms. Certainly, many people have awareness and compassion for others, but some may not be able to accomplish that. And when compassion appears to fail, it could be a case of being triggered by each other’s behavior. More so, the person is likely unaware of being triggered.

Of course, this is a simplified example, but I’m sure you get what I mean. Mental health and addictions already make us raw, vulnerable, and somewhat fearful. Life can feel like swimming through a pool of molasses to get through the day. It makes being aware of our triggers pretty hard to do.

Photo by Kjpargeter on Freepik.com

Triggers, born out of trauma, are basically areas where we haven’t healed, integrated, or accepted something painful. When that pain remains unconscious (something the pysche does to protect us), it often manifests as triggers during periods of stress. These triggers are reminders of past trauma that we’re not aware of.

What’s important to understand is that trauma is a significant root cause of mental health and addiction issues.

On a biological level, our brain struggles to balance neurotransmitters in mental health and addictions. This imbalance contributes to a decline in emotional and physical functioning like decision-making, energy levels, self-esteem, perspective, mood regulation, etc. And a decline in functioning may work together with past trauma to manifest into the behavioral symptoms of mental health and addiction problems.

Often, the synergy of trauma, mental illness, and addictions become a cycle that feeds on itself.

If you don’t already know how closely-tied mental health and addictions are to past trauma, let me share the following statistics. A 2016 study of 68,894 random adults across 24 countries and six continents revealed that 70% of them had a traumatic event. And get this, 30.5% of them had four or more traumatic events in their lifetime.

Indeed, trauma doesn’t always cause mental health and addictions. But studies also show that people with mental health and addiction issues have a much higher rate of trauma than the general population.

Furthermore, trauma tends to be overlooked when treating these disorders. This oversight is why many of us are unaware of our triggers in the first place. And being unaware of triggers is the reason why we even get triggered in the first place.

It’s also important to note that trauma doesn’t have to be severe to cause PTSD or other trauma-related stress. Trauma can be anything from coping with overwhelming change to childhood abuse to systemic racism that results in a lack of access to basic human needs. And unfortunately, most of the ripple effects of trauma are not widely discussed in health care circles.

So, what may look like an insensitive stigma could be a trigger reaction prompted by trauma and the behavioral manifestations of mental health and addiction disorders.

Here’s another example — I’ve caught myself becoming judgmental and irritated whenever I see another person extremely drunk. My actions and words (had I said them out loud) would have been very stigmatizing. But really, my reaction stems from not having healed from the aftermath of my addiction. Nor have I recovered from my familial alcoholism. Do you see how that works?

It seems that the hidden (yet positively charged) relationship between mental health/addictions and trauma makes it difficult for us to navigate each other’s symptoms. In that sense, some of our behavioral symptoms will likely set off a trigger for someone who may be sensitive to these behaviors.

If there is a high prevalence of trauma and a high prevalence of mental health and addictions in the global population, it makes sense that trauma might explain some aspects of stigma.

This doesn’t mean we have to carry the load of other people’s trauma, but knowing this could help us be kinder to ourselves and others. Becoming aware of trauma triggers can help us settle our nervous systems, which may improve our symptoms, and how we relate to others. In this way, we become teachers for one another rather than re-traumatizing each other with reactions and irritation.

How do we do this, you might ask? Before we get to that, let me emphasize that a good therapist can help with all of this. This process is tricky to learn and understand on our own. However, therapy can be quite costly, which means some of us are, indeed, doing this alone.

So here are a few tips to help you with awareness. The first step is always with ourselves — the more aware we become of our triggers, the better. This doesn’t mean we turn into Sigmund Freud and burn ourselves out with analysis. Rather, we take time to learn when we’re getting triggered in the first place.

A good rule of thumb is that if we feel irrationally angry, sad, or fearful with another person, yet can’t put our finger on why — we’re likely experiencing a trigger. It might help to write it down and take a few weeks, maybe a month, to reflect on it.

The next step is to identify why a behavior or situation is triggering us. Go gentle with this one as it will open a few doors to the past that can be uncomfortable. If you can’t afford a therapist, try to find a trusted friend or loved one that can lend some non-judgemental support.

Lastly, by engaging in activities like writing, speaking, creating art, or talking it out, we can slowly re-tell our stories and learn how to integrate trauma. This process takes time and shouldn’t be rushed. It should also be supported by professional help when possible.

You should also know that figuring out why we get triggered may never come to the surface. So if all you can accomplish is to know that you’ve been triggered in the first place, then that’s good enough.

Trauma triggers, mental illness, and addictions correlate with each other. And unfortunately, they can often feed off each other in uncomfortable ways.

So the next time you see an example of stigma around mental health and addictions, consider how trauma triggers may be playing a part. Yes, it’s not the whole picture, but it’s undoubtedly a missing link that we often don’t talk about.

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Former nurse turned alcohol and health writer/researcher. I have extensive experience in administration, frontline care, and education in mental health, public health, and geriatrics. However, after 20 years, I needed a change and always wanted to write. I have personal and family experience in alcohol addiction and mental health. Also passionate about trauma recovery, psychedelics, and psychology. Join my Substack community.


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