It's no big secret that people with mental health issues feel ashamed. I've spoken about this many times on both a personal and a community level. But, with my second session of a renewed CBT course completed today, I have been confronted with something that I think defines me as a person: I am ashamed of who I am.

I have the extraordinary ability to denigrate every aspect of my life. I believe myself to be thoroughly physically repulsive. Not just "I'm too fat" or "My nose is too big" – I literally think of myself as less attractive than the elephant man. I also think of myself as a very self-centred and selfish human being, an unintelligent and ineloquent person, and ultimately a failure.

There are degrees to which this helps me in life, believe it or not. I assume that people must think so little of me that I am quite confident; I take the attitude that "their opinions of me can't possibly get any worse" much of the time, and this allows me a certain level of confidence in an odd way. I also don't worry about relationships or sex nearly as much as my peers. I think to myself "Well, no one's realistically going to be even remotely attracted to you, so don't waste your time". Of course, it's well documented that this isn't always the case... But, for the most part my feelings of shame prevent me from worrying about the aforementioned.

I wonder why it is that people with mental health issues so commonly loathe themselves? Why am I so unwilling to trust people? Why can't I believe that other people can care about me? Why are feelings of self-loathing and shame and isolation such common features in depression?

So many of the messages I've received from people involve confessions of shame and self-loathing. What allows us to think of ourselves as so worthless? There's no evolutionary advantage to seeing yourself as utterly insignificant. And it's not simply that people with mental health issues – from eating disorders and body dysmorphia to bipolar disorder and schizophrenia – are all experiencing an existential crisis. No, we genuinely consider ourselves to be miniature black holes. We think that everything we do has some malignant effect on the universe.

I don't have any answers, but I do have a theory. Perhaps we all share a sense of guilt? We all, at some point, come to recognise that we have a problem of some description, and perhaps we all feel guilty about it? We feel guilty that we aren't 'normal'. We feel guilty that we waste our lives. We feel guilty that we have these disorders which don't feel like disorders when you compare them to, say, cancer. And we feel guilty that we've let others down. Friends, family, colleagues... the world at large!

Shame is a symptom. It causes us to curl in to a metaphorical ball and hide from the world. We want to protect ourselves from the world. We want to protect the world from us. And it's so ridiculous, because it perpetuates the problem! I want to stop being ashamed. I want to stop feeling guilty. Someone said something to me recently when confessing about her eating disorder:

"I wish that I'd felt I could share what was going on in my head as opposed to be ashamed". 

Perhaps there's a key here to improving things on a personal and community level. We need, as a community as well as individuals, to have a "Share not Shame" attitude towards mental illness. 


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