Bipolar stigma is painful in any form, but it can feel especially hurtful when it comes from family, friends, or other people you trust.
Key Takeaways
- Public stigma is real and it hurts, but remember that it usually comes from a place of fear or a lack of understanding rather than your actual worth.
- You don’t have to educate everyone; it’s okay to set boundaries with people who aren’t ready to support you and focus your energy on those who do.
- Having an “action plan” for work or social circles can help you feel more in control when you decide to share your diagnosis.
- If the weight of other people’s judgment is starting to affect your mental health or making you want to skip treatment, reach out to a professional or a support group right away.
_______________
Stigma, no matter where it comes from, is insensitive and dehumanizing.
But when discrimination comes from those we’re close to — friends, family, co-workers, fellow worshipers, others we’d hope would choose acceptance of bipolar disorder over rejection — it can sting even more.
That’s because being able to lean on those we’re most familiar with seems like a no-brainer. But that’s not the case. In fact, sometimes the opposite is true: Instead of support, there seems to be a point at which, at least with regard to nuclear family members, “the stigma might sometimes get worse,” says Patrick W. Corrigan, PsyD, a distinguished professor of psychology at the Illinois Institute of Technology, and a leading expert on the topic of stigma related to mental health.
Wounding words, condescension, or distancing lead to feeling marginalized by the very people we should be able to count on most. And that — like stigma from anywhere — can terribly undermine self-esteem and lower confidence in achieving success, cause depression and anxiety, contribute to social isolation, and interfere with seeking treatment or adhering to a medication schedule.
“There’s this hurtful irony that happens,” says Dr. Corrigan, who’s also the principal investigator of the National Consortium for Stigma and Empowerment and the author or editor of 15 books. “These folks are supposed to be a support to us, and instead, they somehow get sucked into the whole thing.
Sometimes, it can even be those closest to us. A systematic review published in BMC Psychiatry found that caregivers of people with bipolar disorder reported feeling a greater burden compared to caregivers of people with schizophrenia. Additionally, caregivers of people with bipolar had higher perceptions that the illness is linked to violent behavior.
Defining Public Stigma in Bipolar Disorder
Public stigma refers to the negative or discriminatory attitudes that others have about bipolar disorder. Unlike self-stigma (the negative beliefs you may have about yourself) or structural stigma (institutional policies that limit opportunities), public stigma involves the social rejection or stereotypes you face in the world. For example, a father who has bipolar disorder may face judgment from other parents at school, an employee might be passed over for a promotion due to a manager’s misconceptions, or a member of a faith community might be told their symptoms are a lack of faith rather than a medical condition.
How Harmful Myths and Media Portrayals Perpetuate Bipolar Stigma
Such attitudes are too often stoked by myths or the media rather than by scientific information and experience, according to J.D. Van Eaton, a licensed professional counselor in Atlanta.
“When we talk about stigma, it’s not just that people are judging,” he says. “It’s that they are completely misunderstanding and being naive about what bipolar disorder is in general. And the really tough part is, it’s almost like they don’t want to understand it, just to make it easier on themselves.
“Ultimately, it all boils down to fear,” he adds. “We fear what we don’t understand.”
Recognizing Bipolar Stigma in Friendships
Shortly after Keira M. moved to Charlotte, North Carolina, she met someone who had a baby her daughter’s age. They became close friends, and Keira eventually disclosed that she had bipolar 2 disorder.
Soon after, when a mood episode made caring for her daughter intensely draining, she asked her new friend for help. The friend brushed aside the request, chalking the experience up to the challenges of being a new parent.
“So I asked again a couple of days later,” Keira says. “She rolled her eyes.”
This has happened with others as well.
“I’ve tried to share here and there, but it’s not something people can easily relate to,” she continued. “If you say, ‘My mother-in-law is driving me nuts,’ they’re like, ‘Oh yeah, I totally get that.’ But if I say I’m having issues with [my mental health] they say, ‘I know. I get that way when I’m tired.’ I think they are trying to connect, but when I try to explain it’s more than exhaustion, we go back and forth until I give up. They seem to think I’m being very self-centered or trying to elicit sympathy.”
Keira isn’t alone. Although the stigma is improving, it still exists. According to a survey conducted by the American Psychological Association in 2019, 81 percent of respondents would feel comfortable being friends with someone with a mental illness. But 33 percent agreed with the statement “people with mental health disorders scare me,” and 39 percent agreed with “I would view someone differently if I knew they had a mental health disorder.”
Although Keira does still hold back a bit, she’s trying to be more open when establishing new friendships.
“I’m always worried that I’m not getting it quite right — that I’m saying too much or I’m being too closed off,” she says. “I haven’t been the best at keeping friends in the past, but I’m determined to do it now.”
Where Public Stigma Shows Up
Public stigma isn’t confined to one area of life; it often appears in the environments where we seek connection and stability. We see it show up in:
- Friends and family: When loved ones dismiss symptoms as “moodiness” or blame the diagnosis for every disagreement.
- The workplace: When employers reduce responsibilities or exclude people from meetings after a disclosure.
- Religious spaces: When congregations offer prayer but lack understanding of the medical necessity of treatment.
- Healthcare: When providers focus only on the diagnosis rather than the person’s overall well-being.
- Media: When films and news reports rely on dangerous tropes that link bipolar disorder to violence.
When Family Members Blame Bipolar for Everything
Yet, unintentional as it may be, family members can be quick to blame the disorder when they don’t care for a particular behavior or decision, instead of accepting that the decision was purposeful, according to Chicago psychologist Terry Dornak, PsyD.
“This comes up quite often with my clients,” she says. “They’re told, ‘You just did that because you were impulsive at the time’ or ‘You’re acting like this because you must be manic.’ But blaming the disorder makes [people] feel like they’re only a patient.”
If it’s accurate to do so, Dr. Dornak recommends being open about talking to a therapist regularly, being on schedule with medication, and using coping skills — so the point comes across that you’re stable and capable of making thoughtful choices.
Some reactions can be traced to implicit bias rooted in personal history. Given the disorder’s strong genetic component, a family member might have had a negative interaction in the past with another family member with bipolar.
“Maybe they’re holding on to hurts that haven’t been resolved,” says Heather Z. Lyons, PhD, professor of psychology at Loyola University Maryland. “They see someone else behaving in some similar ways that they haven’t gotten closure around.”
Educating Your Loved Ones About Bipolar
Providing some education might help. That negative interaction might have happened decades ago, when there was much less information and fewer treatments available. Just try to be cognizant of the timing.
“There’s this idea of ‘striking while the iron is cold,’” Dr. Lyons says, “so you’re not trying to have a heavy conversation when everyone’s emotions are amped up. Instead, choose a calm time to broach the topic.”
Also, try to be patient. Reflect on how long it took — or is taking — you to truly understand your diagnosis, then realize that others have even less insight into what you’re dealing with.
“They have to go through their own process of learning about this,” Lyons continues. “You can help along the way by providing information, giving them time, being available to talk when they have questions, and recognizing that you can’t force a change in attitude.”
Van Eaton knows from personal experience that while education is the biggest weapon available against stigma, it has its limitations.
“I grew up with friends and family with bipolar disorder, so I’ve been around it my entire life, but there’s no way for me to completely get it because I don’t have it,” he explains. “If your goal is to get other people to fully comprehend what you’re going through, you’re barking up the wrong tree. Just being okay with that is a big thing.”
When Loved Ones Mean Well but Miss the Mark
In a study examining the attitudes about mental health diagnoses on the family level, researchers found that family members of those with mental illness experience three kinds of stigma themselves: stigma, associated stigma, and internal stigma.
Some of that may be attributed to so-called courtesy stigma, what sociologist Erving Goffman, as far back as 1963, defined as a type of stigma by association — when a negative impact results from being connected to a person who is stigmatized.
For Jess M. from California, who lives with bipolar 1, her father’s attempts at support miss the mark. He is perpetually optimistic that she will be able to discontinue her bipolar meds one day, despite her repeatedly telling him otherwise.
“I love him to death, but … it’s sort of like he’s being strong for me instead of just being honest for me,” she says. “I kind of want the honesty sometimes.”
What Should I Share About My Diagnosis in the Workplace?
According to a survey conducted by the APA, approximately half of American workers feel comfortable opening up about their mental health in the workplace. Meanwhile, over one-third of workers reported fearing consequences if they sought mental health treatment.
Unfortunately, after disclosing a mental health condition on the job, it is not uncommon to find one’s work being checked over more often or to repeatedly be asked, “Are you okay?”
Roger R. from Charlestown, Indiana, had done a good job for decades of keeping his bipolar 2 from co-workers he knew well. Even when he was hospitalized for five days after a manic episode, no one knew. He returned to his job as a service manager for a food and beverage company, at first admitting only to having depression. No one treated him differently.
Then he decided to disclose his bipolar diagnosis after being encouraged to do so during a group therapy session. He told a colleague and his boss, who “looked scared.” Within weeks, according to Roger, his job responsibilities were reduced, he was left out of meetings, and he was no longer asked to travel for work.
“I tried to work a little harder, to convey that nothing had really changed, but that caused me anxiety and paranoia about what was going through their heads,” he recalls. “I kept asking myself, ‘Why are they thinking of you like this? They’ve known you for 20 years.’ I tried to suck it up and swallow my pride, hoping one day that things would turn out.”
They didn’t. He kept it up for another two years, then took early retirement. He did end up turning his anger into something positive, however, by joining another support group and becoming vice president of his local Depression and Bipolar Support Alliance (DBSA) chapter.
What It Feels Like to Lose a Job and a Friend at the Same Time
Robert R. of South Carolina is doing his best to cope with losing both a friend and a job at the same time. The friend had helped him get the job in the first place, even after knowing Robert had bipolar 2 disorder.
“I thought that my friend would be someone who was empathetic and knew how to work with me if I experienced an incident at work,” he says.
That friend ultimately became his supervisor. After a hypomanic episode set off a string of behaviors that intensified, forcing Robert to take a few days off, he came back to a meeting with the supervisor and human resources director — a termination meeting.
“My supervisor, using language from an email I had sent her two weeks earlier about what I was experiencing, said, ‘That irrationality is an issue, and it can return,’” remembers Robert, who still gets choked up when discussing the 2016 incident.
He adds, “Regardless of the emotional pain, it’s important to revisit these events over time and re-evaluate them with new perspectives so they can be re-framed as learning opportunities. That’s what healing is all about.”
Addressing Bipolar Stigma in Faith Communities
While older data from LifeWay Research shows that churches typically are supportive when it comes to dealing with mental health challenges, it also reveals that almost 1 in 5 people broke ties with their church because of a negative response — or lack of response — to their diagnosis.
Negative reactions to a diagnosis can take the form of an ill-informed comment — such as “Just pray about it” — to more drastic measures, such as a planned exorcism.
When Katie D., a devout Christian, heard a televangelist in 2018 tell her she could be healed from her bipolar 1 disorder “if she only had enough faith,” she took that as a sign to stop her medication. Two months later, she underwent voluntary hospitalization; it took four more months to settle into a good medication regimen.
Since then, she has mixed feelings about the role that the church plays in erasing stigma.
Katie feels she can turn to her congregation for prayer and to share her burdens, but “maybe that’s because I’m successful and stable. If I shared more about a major episode, I feel like they would be like, ‘Whoa, what is she smoking?’ and they wouldn’t know what to do.
“The church in general has a responsibility to nurture, grow, and lead,” she adds. “But given all the knowledge about mental health stigma we have now, and the anti-stigma research, I don’t think it’s being the change agent it’s expected to be.”
There are ways to identify a more welcoming place of worship, regardless of your faith tradition, says Stephen Grcevich, MD, author of Mental Health and the Church: A Ministry Handbook for Including Children and Adults With ADHD, Anxiety, Mood Disorders, and Other Common Mental Health Conditions.
He suggests asking: Does it offer mental health education or support groups? What about professional counseling services?
“Very few churches have thought through an intentional strategy for including children and adults with common mental [health] conditions” in their offerings, Dr. Grcevich says.
Busting Stigma Through Education
It’s normal to wish that the people we’re around most often, especially those we hold most dear, would accept a bipolar diagnosis — and strive to learn as much as they can about it.
When that’s not the case, we need to look to others we can trust for sources of strength.
“Trust is a key word here,” says Dornak. “You need people who support you and understand that you are not your illness.”
Corrigan, author of The Stigma Effect: Unintended Consequences of Mental Health Campaigns, co-developed the Honest Open Proud program to reduce self-stigma and increase a sense of personal agency.
“We want to empower people with the condition,” Corrigan says, “and those of us without it need to be allies.”
Keira wholeheartedly agrees. “I started trying to grow my tribe for my daughter’s sake,” she says, “but now I realize just how much I need it for me.”
Coping With and Overcoming Public Stigma
While you can’t control the actions of others, you can take control of your response to public stigma. Focus on these action-oriented strategies to protect your well-being:
- Set healthy boundaries: You are not obligated to tolerate “wounding words” or condescension from family members or friends.
- Choose disclosure carefully: Decide who “earns” the right to know your diagnosis, especially in the workplace or new social circles.
- Educate selectively: Provide information to those who are open to learning, but recognize when someone is committed to their misconceptions.
- Find your tribe: Seek out support groups like DBSA or NAMI to connect with people who truly understand the bipolar experience.
Getting Past Bipolar Stigma — Even if Others Can’t
You can’t control whether other people buy into the stigma around bipolar, but you can take control over how you respond. Here are some tips for preventing fear and ignorance from leading to self-doubt:
- Realize your strength. Just because bipolar requires constant monitoring doesn’t mean you can’t have a fulfilling life. “I’ve seen more success with my clients who have bipolar because they have to be so introspective and work so hard,” says Van Eaton.
- Get support. In addition to counseling, seek out a support group. “It helps you deal not only with your illness, but also your feelings,” says Roger. “And it’s good to know you’re not the only one out there going through this.”
- Educate others. You can’t make someone understand what you’re going through, but you can pass along information about bipolar to foster a more open mind. If you’re comfortable, you can also invite a parent, sibling, partner, or friend to a joint therapy session.
- Be prepared. If you’re going to disclose your diagnosis at work, ask your supervisor or the human resources director what accommodations can be provided for someone with bipolar disorder. Have an action plan in place to take care of yourself when you are ill, regardless of whether or not you disclose.
Editorial Sources and Fact-Checking
- Karambelas G et al. A Systematic Review Comparing Caregiver Burden and Psychological Functioning in Caregivers of Individuals With Schizophrenia Spectrum Disorders and Bipolar Disorders. BMC Psychiatry. June 23, 2022.
- Survey: Americans Becoming More Open About Mental Health. American Psychological Association. May 1, 2019.
- Gaolalwe W et al. Family Members’ Experiences of Courtesy Stigma Associated With Mental Illness. Health SA Gesondheid. August 29, 2023.
- Moran M. Mental Health Stigma Persists in the Workplace, Poll Shows. Psychiatric News. June 18, 2019.
- Study of Acute Mental Illness and Christian Faith: Research Report [PDF]. LifeWay Research. 2014.
UPDATED: Originally printed as “When Stigma Strikes Close to Home,” Spring 2019
