The first time I told someone that I was mentally ill, they reacted with disbelief.

“You?” they asked. “You don’t seem that sick to me. Be careful not to play the victim.”

The second time I told someone that I was mentally ill, they invalidated me.

“We all get depressed sometimes,” they replied. “You just have to power through it.”

Countless times, I’ve been made to feel like my mental illness is my fault. I wasn’t trying hard enough, I needed to change my perspective, I wasn’t looking at all of my options, I was exaggerating how much pain I was in, I was only looking for sympathy.

If I wasn’t mentally well, they implied, it was obviously an issue with me that had nothing to do with the systems that fail mentally ill people each and every day. My “failure” to live a functional and happy life had nothing to do with the biological, psychological, and sociological factors that contribute to mental health. Instead, it always seemed to circle back to me and an apparent lack of willpower that kept me down.

For a while, this kind of gaslighting – the denial of my struggles that made me question my own reality – had convinced me that my mental illness wasn’t valid or real, and what was intended to be “tough love” from the people around me only made things worse by leading me to blame myself instead of advocating for the kind of treatment I desperately needed.

Like many mentally ill folks, it was impossible for me to move forward in my recovery until I stopped blaming myself and started seeking out the right kind of support. But it can be impossible to do this when the people around you are convinced that you’re doing something wrong.

A culture that routinely traumatizes mentally ill people by interrogating the severity of our illnesses and the sincerity of our efforts – effectively blaming the victim – is a form of psychological violence that keeps us from accessing the care that we need.

And yet it’s the norm in this society. People seem to have a lot of opinions on the choices that mentally ill people are and aren’t making while staying silent about the systems that force us to make less than ideal choices in the first place.

Personally? I believe that any choice made in an effort to survive is not necessarily a “wrong” choice, and if we care about mentally ill people, it’s our job to expand those choices by increasing their efficacy and accessibility rather than punishing mentally ill folks for doing their best to navigate their illnesses in circumstances that will never allow them to thrive.

As a mentally ill person, I have struggled within a culture that compulsively critiques the choices that I’ve made rather than advocating for the availability of better choices. And these critiques leveled against me, perhaps with the intention of motivating me, have ultimately hurt me.

I want to unpack those criticisms. The reality is that they harm not just me, but the millions of people that grapple with these illnesses every day.

And unfortunately, it’s a conversation that is increasingly necessary as support and resources for psychiatrically disabled people are only disappearing under the new administration, fueled in part by these prevalent beliefs about mentally ill people.

Here are four ways mentally ill folks are blamed for what they’re going through and what we can learn from these harmful assumptions.

1. We’re Expected to Pull Ourselves Up By Our Bootstraps

I remember when my old therapist told me, “If your mental illnesses were just an attitude problem, wouldn’t you have changed it by now?”

When I hesitated, she added, “I don’t think you’d make yourself suffer this deeply and this much if the solution were that simple.”

And she was right. I was doing everything that I could. My struggles were not due to a lack of effort on my part. I would’ve done anything if it meant finally getting better.

People who haven’t experienced mental illness personally often buy into the idea that if you try hard enough, mental illness is something you can overcome. With one brushstroke, it’s depicted as a lack of willpower and a personal failing. Myths like this disempower mentally ill people because they take the focus away from creating resources to help us and instead place complete and total responsibility on the person who’s suffering to make solutions appear out of thin air.

But if we could single-handedly ease our suffering, wouldn’t we have already done it? It isn’t fun, and for many of us, it disrupts our lives in significant and even unbearable ways. In fact, it’s the leading cause of disability worldwide.

When you place the burden on mentally ill people rather than advocating for a system that supports us, you put our lives in danger. Not only are we less likely to seek out help if we’re expected to go it alone, but legislators won’t think twice about slashing funding if it’s treated as an attitude problem rather than a legitimate public health issue.

No one wins when we abandon mentally ill people.

2. It’s Assumed That Treatments Will Be Accessible, Quick, and Effective

It took me over a decade from when my symptoms first appeared to get the right treatment.

And that bears repeating: over 10 years.

My case is exceptional, too. Most people will take at least ten years just to seek out help for the first time, and many will never receive treatment at all. This gap in care can account for the significant rates of drop-outs, hospitalizations, imprisonment, and homelessness that are a staggering reality for people with mental illness in this country.

It is incorrectly assumed that if you’re struggling with mental illness, a good therapist and a pill or two can easily remedy the situation.

But that’s assuming:

  • The stigma and cultural norms have not discouraged you from seeking out help
  • You have geographically and financially accessible options
  • Treating neurodivergence as an illness is a framework that serves you OR alternatives that resonate with you can be accessed
  • You have adequate insurance OR access to resources designed for folks without it
  • You understand how to navigate these systems and can find what you need
  • You can safely take medications and you respond to the medications prescribed to you
  • You were accurately diagnosed
  • You have the necessary self-insight to recognize your triggers and symptoms and can convey them to a clinician
  • You have the stamina and time to endure years of testing out different treatments to figure out what works
  • You have trusting relationships with the clinicians directing your recovery

…which only happens after you are willing to sit on a waiting list for weeks and even months to see those clinicians in the first place or can seek out crisis services (like the emergency room) sooner.

Does it sound like a lot? That’s because it is. And this isn’t even a complete list by any stretch.

Of course, if you’re multiply-marginalized, forget it. You not only have to wait for a clinician to see you, but you need a culturally competent one that understands the context of your unique struggles.

This is damn near impossible for many of us, as psychiatry as a profession is still dominated by clinicians who hold a lot of privilege and can replicate these hierarchies in their work. Instead of addressing the laundry list of reasons why mentally ill people don’t get treatment, it’s just assumed we’re not trying hard enough or that we don’t want to get better. This is a fallacy designed to prevent us from accessing care and perpetuates a broken system that does not serve us adequately or compassionately.

3. We’re Not Allowed to Feel Discouraged or Defeated

Behind all of the pressure to “keep trying” and all the suggestions that we’re never quite doing “enough” to get better is the implicit message that mentally ill people are not allowed to feel defeated. We’re not allowed to momentarily give up, hang up our gloves and say, “This isn’t working, and I’m tired.”

If we aren’t constantly “on” and working at recovery, it’s suddenly our fault that things aren’t improving. If only we’d just put in the effort, things wouldn’t be this way. Never mind that we’re human beings, and sometimes it’s just too overwhelming or painful to keep going.

A culture that treats mental illness as a lack of effort is a culture that says mentally ill people aren’t allowed to be fully human and vulnerable. It dictates that the effort is our sole and constant responsibility, and that we aren’t allowed moments in which we can grieve, give in, or be afraid.

The expectation that mentally ill folks are doing something wrong if they aren’t constantly in motion is an unrealistic and unfair burden to place on us, especially because the level of dysfunction that mental illness can present can make it nearly impossible to advocate for ourselves in the first place.

Feeling discouraged is valid. Feeling afraid is valid. Feeling exhausted is valid. There is a full spectrum of emotion that comes with recovery, and part of humanizing mentally ill folks requires that we hold the space for those emotions.

Recovery is a discouraging, scary, and exhausting process that can wear down the most resilient among us. This has nothing to do with mentally ill people’s personal failings and everything to do with the fact that these illnesses can be difficult to live with.

If you blame us for not trying harder or trying enough – demonizing those moments when we feel most vulnerable or defeated – what you’re saying is that if we aren’t superhuman and invulnerable, our pain is deserved.

This is untrue. We don’t deserve this. And we certainly didn’t ask for it.

4. We’re Either Too Functional to be Sick or Too Dysfunctional to be Helped

Here’s one of those ways in which mentally ill folks can’t win: we’re either too “functional” by appearances and therefore making excuses for our shortcomings, or we’re too “dysfunctional” and we’re a burden on society that can’t be helped.

Either way, rather than acknowledging the impact mental illness has on us, people tell us that in both scenarios, the problem lies with us.

It personalizes our struggles in a way that is dehumanizing. We’re seen as either dishonest or insane, and in either case it’s our responsibility to deal with it rather than society’s collective responsibility and ethical obligation to set up systems that allow us to heal.

And as with all of the myths we’ve broken down in this article, this is how oppression operates at its most insidious level: by decentering the systemic origins of human suffering and instead placing the responsibility and blame on the individuals who are suffering. If we categorically write off mentally ill people by either invalidating the authenticity of their struggles, or pushing them off to the margins as irredeemably lost, we no longer have to be accountable for what happens when our systems fail them.

Though attitudes like these remain the status quo and might initially seem benign, they create a protective shield that obscures what’s really at play.

It’s ableism, plain and simple.

Victim-blaming folks with mental illness is not just a matter of stigma, though we can easily recognize it as such. It’s also a form of violence; it directly upholds a system that harms the psychiatrically disabled and deflects accountability for that harm.

We can all do better than this, and it starts by putting the blame where it really belongs – not with mentally ill folks who are only trying to survive, but with the systems that fail us, a society that gaslights us, and the violent attitudes that embolden them both.


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  1. Thank you, Sam. Working within the treatment system, I’ve seen all of that, seen it fail too many times, some of those times, fatally. Never, in all that time, did I have at hand all the resources and options I wanted for the people I served. Funding doesn’t keep up with costs and programs are cut back or closed. Programs and resources are designed and planned, funding is promised, and then there is no place to set them up because nobody wants “those people”, the mad, the strange, the addicted, the unwashed homeless, etc. in their neighborhood. OK, enough rant. You nailed it as usual, Sam.

    Liked by 2 people

  2. I feel, also, that the tendency to use “mental illness” as a derogatory label aimed at criminals has hurt those who truly need help. “Mental illness” can be anything on a huge spectrum, not a one-size-fits-all descriptor of irrational behavior, which is what it’s come to mean now. People who criticize friends and family who suffer appear entitled to make (completely inaccurate) diagnoses.

    [sarcasm]Since you don’t fit the image of a raving mad-person then you’re not mentally ill. Get over it.[/sarcasm]

    Views of mental illness are so negative that it becomes impossible sometimes to advocate for our friends and family who deal with it. I find silence and circling the wagons is my go-to right now concerning my son and his struggles. If it weren’t for me recognizing the signs that he needed help, who knows how long he would have gone without it.

    Even with insurance, his therapists haven’t been covered — all very expensive out of pocket for us, but worth it. I would go bankrupt for my son. I find it amusing, though, that his meds have amazingly low co-pays compared to my birth control…

    Liked by 2 people

  3. This is why I mostly make friends with other folks who have histories (or currently deal w/) mental health stuff…though that can make staying sane-ish tricky. We have to draw boundaries when someone goes too far. That’s also most of my family…the idea of seeing therapists & taking meds is as normal as shooting insulin in a family of diabetics…the stigma of society as a whole is kind of a culture shock to me. Somehow multigenerational addicts/alcoholics (or in recovery) seems more “normal” and quasi-acceptable, than mostly dry mad folks but it might just be one of those “grass looks greener on other side” things.

    Liked by 1 person

  4. This really spoke to me on a personal level. I admire your bravery for speaking the truth like this. Every single point was like hitting the nail on the head… Thank you for writing, thank you for sharing, thank you for letting others see that mental illness is not something we can just “deal” with. It is so HARD to find the right treatment without feeling like a human guinea pig. There are so many times you want to give up. And sometimes when you find the right medicines/therapies that work for you, they can suddenly STOP working and you’re back to square one! No one would CHOOSE to live life this way. We all do the best we can, but sometimes the best we can… isn’t good enough and can lead to certain death.

    Liked by 1 person

  5. Hello Sam: I just stumbled across your blog site & had to read some of your posts! You are a wonderful & gifted writer. And this blog post touched my heart ALOT> I’ve suffered from Clinical Depression since I was 15 & I’m now 61. Every Anti Depressant I’ve tried had adverse effects. My body would reject the meds & I’d throw them up. So-o I’ve been managing on my own with Counselling at the local Brief Counselling Unit where I live.
    I agree with everything you wrote….it resonated with me.
    I’ve been in Trauma Counselling since May & this time around I feel I’m being heard. Thank you again for sharing your journey with the world.
    Sincerely, Sherri-Ellen T-D.

    Liked by 1 person

  6. Wow! This article really spoke to me. I have been struggling with depression, and people don’t seem to understand. How would they feel if they were so discouraged by their failures that they had to fight against a heavy burden of misery and discouragement? How would they feel if they tried to be happy and cheerful, but they still struggle with fatigue on the best of days? Let’s see them live the hard life I have and try to stay as sane as possible. The worst part is the times when suicidal thoughts creep in, and even survival becomes an uphill struggle. My point is that people don’t get me. This article is amazing in that it describes the mental health stigma with so much insight and honesty. Finally there is someone who would actually get what I am going though. I am interested in mental illness, and this article really helps me understand what it is like for the people that have it. The article nailed it when it called the stigma a kind of ableism. I was thinking the same thing.

    God job! Good luck on your recovery!

    Liked by 1 person

  7. You brought me to tears with this one, Sam. Good tears. To be validated and really understood is an emotional experience that goes straight to the heart. Thank you.

    I originally read this on Healthline. It’s good to see your message spreading beyond your own website, so more people can hear it.

    I’m an example of searching for the right treatment for years. For 13 years, a variety of therapists and shrinks tried without much success to treat me for depression. One psychiatrist (in his notes, not to my face) diagnosed me with “Major Depressive Disorder (Treatment Resistant)”.

    Finally, two years ago, my then-current therapist and my psychiatrist surprised me in a joint session by ̶o̶r̶d̶e̶r̶i̶n̶g̶ ̶ strongly suggesting that I seek a new therapist, one that specializes in Complex PTSD, and has a track record of working with trans people.

    Two years of working with that new therapist have helped me to rid myself of my most self-destructive behaviors, to understand my illness, and to help me dig out from under my feelings of despair, hopelessness, and feeling overwhelmed by life. No, she hasn’t “cured” me, but I feel more capable than I have in a long time. I see sunshine on the path ahead, even if I’m still in the dark. I have hope.

    The point of my long story: It can take you a long time to find the right treatment for you, especially when others deny the illness, or when they write you off as ‘treatment resistant.”

    Liked by 2 people

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