# Depression, Stigma, and the Soul *Exported from [Holy-Writings.com](https://www.holy-writings.com/) on 2026-06-18 — 1 clipping.* --- > Depression, Resumé > La dépression majeure est une crise sani- > Stigma, and the taire mondiale. Elle est complexe et source > de confusion, et la majorité des personnes > Soul qui en souffrent ne reçoivent pas l'aide > dont elles ont besoin. La stigmatisation > liée à la dépression et aux autres mala- > PATRICIA A. MCILVRIDE dies mentales constitue le principal frein > à une prise en charge efficace. Cette stig- > matisation, qui est au cœur de l'histoire, > O my Lord, my Beloved, my Desire! de la culture – voire du modèle médical, > Befriend me in my loneliness and ac- empoisonne la perception du public envers > company me in my exile. Remove my les personnes ayant une maladie mentale. > sorrow . . . Verily, Thou art the Gra- Cette stigmatisation publique amène les > cious, the Generous. personnes qui vivent une dépression à > —'Abdu'l-Bahá, Bahá'í Prayers se stigmatiser elles mêmes, nuit à leurs > rapports avec les autres et entraîne, par- > Abstract fois, un sentiment de désespoir pouvant > Major depression is a global health cri- conduire à des idées autodestructrices > sis; it is complex and confusing, and the ou au suicide. De nouvelles approches en > majority of people who need help do not matière de rétablissement, notamment > receive it. The stigma attached to depres- celles offertes en neurobiologie interper- > sion and other mental illnesses is one of sonnelle, remettent en question le modèle > the greatest barriers to effective treat- médical utilisé pour le traitement de la > ment. Embedded as it is in history, culture, maladie mentale. En définissant l'esprit > and even in the medical model, stigma has comme étant transcendant et à la fois in- > poisoned the public's perception of those carné et relationnel, de nouveaux modes > who suffer from mental illness. Public de rétablissement deviennent possibles. > stigma also creates "self-stigma," thereby Les personnes aux prises avec des prob- > causing disconnections in relationships lèmes de santé mentale parviennent à la > and, sometimes, a despair that can lead to santé lorsqu'elles créent leur propre plan > self-destructive feelings or suicide. New de rétablissement et font appel au pouvoir > recovery models including those offered guérisseur de l'âme et qu'elles bénéficient > by interpersonal neurobiology are chal- de milieux aimants et éclairés qui les sout- > lenging the medical model in the treat- iennent en maintenant avec elles des liens > ment of mental illness. By defining the d'amitié exempts de jugement. > mind as transcendent and both embodied > and relational, new avenues of healing Resumen > become possible. Health is realized when La depresión mayor es una crisis glob- > those with mental health challenges create al de salud; es complejo, crea confusión y > their own recovery plans and draw on the la mayoría de las personas que necesitan > healing power of the soul within loving ayuda no la reciben. El estigma atado a la > and educated communities that support depresión y otras enfermedades mentales > them with friendship, not judgment. es una de las barreras más grandes para > 64 The Journal of Bahá'í Studies 27.1-2 2017 > > el tratamiento efectivo. Estando arraigado this end, he began to carry through > en la historia, la cultura y hasta en el mod- a plan he had been contemplating > elo médico, el estigma ha envenenado la for many years—since adolescence, > percepción del público acerca de aquellos in fact. He bought a large supply of > quienes sufren de enfermedad mental. El over-the-counter painkillers, sleeping > estigma público también crea "auto-estig- > pills, and other drugs, and he resolved > ma", causando así desconexiones en las > to take them all at once. > relaciones y, a veces, un desespero que > puede llevar a sentimientos auto-destruc- > When he got home, he sat down to > tivos y de suicidio. Nuevos modelos de re- write a goodbye note to his family, but > cuperación incluyendo aquellos ofrecidos at that moment, his wife returned ear- > por la neurobiología interpersonal están ly from work and interrupted his plan. > desafiando el modelo médico en el trata- She took him to the emergency room. > miento de la enfermedad mental. Al definir He told the doctor his story, adding > la mente como trascendente y tanto en- that those negative feelings from a few > carnado como relacional, nuevas avenidas hours earlier had lessened while he > de sanación se hacen posibles. La salud es had been sitting in the waiting room. > realizada cuando aquellos con desafíos de He said that he loved his family and > salud mental crean sus propios planes de wanted to go home. The doctor took > recuperación y toman del poder sanador > blood tests; did a chest X-ray; exam- > del alma, dentro de comunidades amoro- > ined his heart, lungs, eyes, ears, nose, > sas y educadas que los apoyan con amistad > y no juzgándolos. > and throat; and pronounced, "OK, you > can go home. There is really nothing > INTRODUCTION wrong with you. The problem is all in > your head!" > I have been a psychologist for most of The world is full of people like > my life. A number of years ago, a man George—men and women, children > I will call George came to see me and and teens, who suffer from major de- > told me a story that was shocking but pression. According to the latest infor- > not unusual. George was thirty-two mation from the World Health Organi- > years old and had a good career, a wife, zation, depression is the leading cause > and a one-year-old child. He said that of ill health and disability worldwide. > he had been suffering from major de- According to their estimates, more than > pression most of his life, but about a 300 million people are now living with > month before our visit he had finally depression, an increase of more than > lost hope of ever recovering. Although 18 percent between 2005 and 2015. De- > religious, he believed God would un- spite the fact that depression is treat- > derstand that the world would be bet- able, nearly half of the people who suf- > ter off without him. He was in such fer from it do not get the help they need > severe and unbearable emotional pain and the figure is much lower in poorer, > that he decided to take his own life. To less developed countries (WHO n.p.). > Depression, Stigma, and the Soul 65 > > "Depression: A Global Public Depression and other major mental > Health Concern" reported results illnesses affect not only those who suf- > of the World Mental Health Survey, fer from them, but also their families, > which was conducted in seventeen friends, coworkers, and community > countries and found that on average, members. Often both the sufferers > about one in twenty people report and those who care for them are at > having had an episode of depression a loss about what to do. Even when > in the previous year (Marcus et al. 6). urged to get help, many with mental > About one million people take their health problems seem to resist. Why? > own lives each year. For every person And what can be done to remedy this > who commits suicide, twenty more problem? > make an attempt (Marcus et al. 6). The goal of this discussion is four- > The burden of depression is 50 fold: first, to describe major depres- > percent higher for females worldwide sion; second, to explain the history > across all income levels. One or two and dynamics of the stigma attached > new mothers out of every ten will suf- to major depression and other men- > fer from depression after childbirth. tal illnesses; third, to show that stig- > Depression limits the mother's ability matizing others or oneself as being > to care for her child and therefore can "mentally ill" can be a deterrent to > treatment and implies (contrary to the > seriously impact the child's growth > Bahá'í teachings) that such illnesses > and development (Marcus et al. 6). > impede the progress of the soul; and > According to data compiled by the > fourth, to show how the concept of > Centers for Disease Control (CDC), > "accompaniment" can be a major con- > although more women than men are > tributing factor to healing when it is > depressed, men are less likely to get > informed by a scientifically sound and > help and more likely to commit sui- > empathic understanding of the illness. > cide (1). Suicide was the tenth leading > cause of death in the United States for CONFUSION ABOUT DEPRESSION > all ages in 2014, and men took their > own lives at nearly four times the rate The word depression itself is very > of women, representing almost 78 confusing. Webster's Dictionary > percent of all suicides (1). gives twenty different definitions for > Depression typically starts at a the word; only three of them refer > young age, and depressed children to mood issues. Depression, among > and teens often go untreated. Lack of other things, can be an area of low > treatment has led to increasing sui- atmospheric pressure, a downturn > cide rates among the young. Suicide in the economy, or low-lying land > was the second leading cause of death ("Depression"). > in the age groups 10–14, 15–24, and Even when referring to an emotion- > 25–35 in 2014 (CDC 2). al state, in English-speaking countries > 66 The Journal of Bahá'í Studies 27.1-2 2017 > > the word depression is often used in at depression would do the same. In a > least two ways: (1) to describe things, sense, it is understandable: the words > events, or circumstances in the present depressed and depressing are often used > or in the past that cause a generally in everyday speech to mean "unhappy" > negative emotional state, and (2) to or "disappointing" or to signify other > denote the presence of a major mental negative emotional states. For instance, > illness—as in clinical depression (also a real estate salesman might drive > known as major depression) or unipo- through a "depressing" neighborhood. > lar mood disorder.1 Teenagers without a date to the prom > In George's example, the doctor might say they are "depressed" because > who told him that his problems were they will miss the event. A woman who > "all in his head" was engaging in this loses an election to the school board > confusion. George had a major mental might say she is "depressed" about it. > illness (major depression) and needed In all these circumstances, a person is > immediate comprehensive treatment. experiencing a passing state of nega- > Because the doctor could not see it tive emotion. Such occasional sadness > with his own eyes or measure it by is a normal aspect of everyday life. > common medical tests, he decided that When one is experiencing this kind > the problem was not real. In making of everyday sadness or lowered mood, > this fundamental error, he was blam- advice to ignore the problem, get busy > ing George for his illness and put- with other things, or "look on the > ting the onus on him to get over his bright side" may actually be helpful. > problems by himself. This error could However, saying the same to a person > have cost George his life, but, luckily, who is suffering from major depression > George sought treatment elsewhere on or other major mental illnesses inflicts > his own. The emergency room where a kind of cruelty upon them. It trivial- > he had been seen was also contacted, izes the seriousness of the illness and > and this incident was reported. On adds to it a sense of guilt, shame, iso- > follow-up, it was found that the erring lation, and hopelessness. It is like say- > physician had been reprimanded and ing to a person with a broken leg, "You > sent for further education about mental should be more careful" or "It is noth- > illness. ing. Just hop," or saying to a person > If a trained physician can make such having a heart attack, "No need to see > a mistake, imagine how much more a doctor. You are probably just out of > likely it is that friends, family members, shape. You need to get more exercise." > and associates of those who have major > DIAGNOSING DEPRESSION > 1 Bipolar mood disorder also includes > periods of major depression as well as The definitions of mental illnesses are > periods of extremely elevated or agitated published by the American Psychiat- > mood. ric Association in various editions of > Depression, Stigma, and the Soul 67 > > the Diagnostic and Statistical Manual and social factors determine the onset > of Mental Disorders. The latest edition and course of illnesses. Biological fac- > of this volume is DSM-5, published in tors like genetic predispositions and in- > 2013. The first, DSM-I, was published herited vulnerabilities are key factors. > in 1952. The World Health Organiza- Psychological contributors include > tion has its own coding system, pub- developmental experiences, personal- > lished in the International Statistical ity, intelligence, beliefs, attitudes, and > Classification of Diseases and Related other variables. Social factors are, for > Health Problems (ICD). ICD-10 is the example, race, ethnicity, socioeconom- > current version. This system is used ic status, family relationships, school, > most often for billing purposes. work-related variables, community re- > DSM-5 is a large book that gives lationships, and religious affiliation. > detailed explanations of the symptoms Despite this complex interplay, biol- > of the illnesses and summarizes what ogy alone can play a determining role. > is known and not known about their For instance, in our example, George > course. Through the various revisions reported virtually no problems with > of DSM, different diagnoses have been his childhood, work, relationships, or > added or removed. For instance, "neu- family life. He had a pleasing person- > rosis" appears in DSM-I and II but was ality, low stress, and what appeared to > eliminated from DSM-III and later others to be a successful life. Yet he had > editions. been chronically depressed all his life. > Psychiatric diagnosis can be chal- For one whose first-degree relatives > lenging because it relies on self-report have major depressive disorder, the > and similar symptoms can apply to lifetime risk of developing the disor- > more than one diagnostic category. Of- der is two to four times greater than > ten, more than one diagnosis is appro- for those without this risk factor. In his > priate. For instance, substance abuse "Overview of the Genetics of Major > disorders are often concurrent with Depressive Disorder," Falk W. Lohoff > depression, anxiety, or other mental reports a recent review of twin studies > illnesses. that estimates heritability at 37 per- > While the symptoms of mental ill- cent, "with a substantial component of > nesses can be grouped together and unique individual environmental risk > given labels, their causes are often com- but little shared environmental risk" > plicated or unknown. Only the trau- (540). > ma-related disorders like post-trau- > matic stress disorder have specific and HOW EXPERIENCES OF DEPRESSION > identifiable causes—that is, the trauma DIFFER > itself. > Scientists now use a "biopsycho- Given that the word depression can in- > social" model to understand mental dicate "just a bad day" or a major men- > illness, meaning that complex interac- tal illness, how can an observer tell the > tions among biological, psychological, difference? The answer is, you cannot. > 68 The Journal of Bahá'í Studies 27.1-2 2017 > > There are many reasons for this. De- move,' and they say, 'Did you put the > pression symptoms differ from person key in the ignition? Did you check the > to person and may vary from day to gas? How old is the battery?' And it > day. Those who suffer from it often makes me mad because the problem is > hide or minimize their symptoms, none of the normal things you think > or they may not even know they are about. There isn't a cause that makes > depressed. any sense. There isn't a solution either > Depression is almost impossible to because nothing in your life explains > describe and even harder to compre- how unbearable you feel." > hend unless it has been experienced Cyrus, a young African-American > first-hand. Nevertheless, I asked man, described depression as a "fun- > friends, family members, and former damental confusion between pleasure > clients to help me try to describe what and pain." He said that when he is > it is like to be depressed (names have depressed, nothing that used to bring > been changed and descriptions edited pleasure is even remotely of interest. > for confidentiality). In addition, he explained, "The feel- > A middle-aged man named Ken ing of not being like anyone else is > described it this way: "When you are huge. You feel like you don't deserve > depressed, life is a struggle, a burden, anything either. You feel so different, > like carrying a one hundred-pound so apart from everyone, and so unable > weight on your back all day every to begin to explain it even to yourself. > day. It is hard to get out of bed in the There is no choice except to be alone > morning. Sometimes, I eat and eat and and hide." > eat just to try to get some energy, but Li, an elderly Asian woman who > then, sometimes, I have no appetite at has had recurring bouts of depression > all. Over the years, I have gained and all her life, explained that when she > lost weight like crazy. The same with feels "normal," she can't even remem- > sleep. Sometimes I want to sleep for ber what it felt like to be depressed: "It > days and can hardly move, then other feels like that depressed person was > days I'm so agitated, I toss and turn someone else." But when the cloud of > all night. I can't say I am sad. It feels depression begins to rise, it beckons to > more like a numb nothingness that her, calls her, as if to home. Although > makes me feel profoundly ashamed vaguely recognizable as a state of pain > and guilty. I know I have no reason to and despair, it also feels familiar and > feel this way, but knowing it doesn't therefore strangely attractive. As the > change anything. My thoughts seem condition gets worse, she sinks into it > to have no power over my emotions." and away from her previously healthy > A teenager named Josiah said it is life. She becomes lost in the darkness > "like trying to drive your car when of her low mood and increasingly un- > the engine is dead. I tell someone, 'I able to function. At her lowest point, > am not going anywhere; I can hardly she may have only a vague, faint > Depression, Stigma, and the Soul 69 > > remembrance of her formerly healthy not knowing how to even answer that > self. question"; "just trying to survive, and > Doris described depression as "a make it through another day"; "weak- > black cloud invading your mind, over- ness, black men can't be depressed"; > whelming your thoughts and senses, "wishing that more people would un- > the mental equivalent of being naked derstand that you're not choosing to > in the cold—no blanket, no warm fire. be like this, you're not just lazy." The > And at the same time there is a knife tweets go on and on, reflecting the fact > stuck in you and you can't escape it be- that depression is a complex, highly > cause it feels like it is you, and the only individualized experience. Between > escape is to destroy yourself. Your persons, symptoms can look quite dif- > survival instinct is overridden by the ferent, and within any individual per- > enormity of the pain and the inescap- son who is depressed, symptoms can > able nature of it. It feels like oppres- fluctuate greatly from day to day or > sion coming from an unknown place." week to week. > She added poignantly, "The worst Depression can wear the mask of > form of oppression is when your own other problems. It can seem like lazi- > mind turns against you." ness, lack of motivation, or procrasti- > nation. It can feel like being "burn out" > THE MANY MASKS OF DEPRESSION or having a "mid-life crisis." Because > depression can cause fatigue, aches, > A recent Twitter conversation pains, and a feeling of being slow, > (#mydepressionlookslike) gives a heavy, and ready to give up on life, it > glimpse into the many faces of depres- can be misinterpreted as a sign of ag- > sion.2 Many tweets express the painful ing. Problems with concentration or > loneliness and isolation of depression, memory may suggest early dementia. > the need to hide the illness, and the Common physical symptoms like low > feeling that no one really understands. energy and problems with sleep and > Examples include, "I'm absolutely fine, appetite could suggest a medical prob- > literally, you wouldn't know anything lem, while less common symptoms like > was wrong by looking at me & that's cardiac arrhythmias, loss of libido, > the dangerous part"; "smiles, cookies, loss of hearing, decrease in body tem- > tears in the bathroom, running, laugh- perature, sweating, nausea, vomiting, > ter, screaming into a pillow"; "kind- dizziness, sensations of cold, etc., are > ness to others but not myself "; "being frequently misdiagnosed as medical, > told 'I'm too bubbly and happy to be rather than psychiatric, problems. > depressed' which only reminds me of Depression can masquerade as anx- > the facade I portray every day"; "be- iety, and because these conditions often > ing always asked 'what's wrong' but occur together, many people think that > 2 See http://twitter.com/hashtag/ their depression is "just stress." Anxi- > mydepressionlookslike/. ety can express itself as nervousness, > 70 The Journal of Bahá'í Studies 27.1-2 2017 > > restlessness, tension, feelings of im- He is not alone. Stigma has been > pending danger, panic, doom, and identified by experts as the single > worry. It can include physical symp- leading cause of treatment avoidance. > toms like heart palpitations, sweating, The following story will illustrate > and rapid breathing. Anxiety attacks, how prejudices and false ideas work > also known as panic attacks, can mimic to needlessly prolong the suffering of > the feelings of a heart attack. those who need professional help. > Chronic feelings of depression and > anxiety sometimes lead to addictive HOW STIGMA PREVENTS TREATMENT > behaviors meant to mask or reduce > internal distress. Over time, addictive Juanita came for counseling at the > behaviors become problems in and of insistence of her parents. She had re- > themselves. Addictions include not cently become engaged and had asked > only drug and alcohol abuse, but also her parents for permission to marry as > things like obsessive over-work, eating Bahá'í law enjoins. They had refused, > disorders, excessive exercise, Internet insisting that she see a counselor be- > addiction, sex addiction, gambling, and fore they would agree to discuss it > other obsessive behaviors. > again. > Despite the complexity and over- > Juanita, by now in her mid-thirties, > whelming difficulty of living with > had experienced a lifetime of struggle > major depression and other mental > with depressive symptoms including > illnesses, people manage to do it. In > low mood, crying spells, problems > fact, many famous and successful > people have suffered from major de- with decision-making, procrastina- > pression including Abraham Lincoln tion, and feelings of insecurity. How- > and Winston Churchill (Solomon, ever, she did not believe that she was > 367). Writers Ernest Hemmingway, depressed. She was fine—after all, she > Walt Whitman, Mark Twain, Stephen was getting married! > King, and J.K. Rowling have openly After doing some work with me, > admitted to battling low moods, while Juanita began to realize that she was > entertainers like Billy Joel and Ray using her relationship with her pro- > Charles expressed their inner strug- spective husband as an "anti-depres- > gles through music. Prince Harry of sant." When she was around him, she > Great Britain has recently opened up felt less sad and more like herself. In > about his chronic depression caused by her mind, the relationship "proved she > unresolved grief over the death of his was normal" and not "a crazy woman." > mother, Princess Diana, when he was Admitting the need for treatment, she > only twelve years old. He now speaks explained, would lead to a downward > candidly about his difficulties, includ- spiral that would cause her to "end up > ing delaying treatment because of the in the loony bin." She believed that > stigma of mental illness, and is urging "fighting" her illness meant avoiding > open conversations about these topics. treatment, while admitting her need > Depression, Stigma, and the Soul 71 > > for help was tantamount to "giving that they believed seeking help for de- > in." She also believed that if she took pression was a sign of a poor charac- > anti-depressant medication she would ter, weakness, and not relying enough > get "hooked on drugs" and would have on God. Juanita thought that if she > to take them for the rest of her life. prayed properly, God would take away > She said she did "not want to get her her depression. It followed that if He > happiness from a pill." These are com- didn't, it meant that she wasn't pray- > mon fears and misconceptions that are ing right or hard enough. > erroneous. Juanita not only believed her own > Getting help decreases the severity prejudices about getting help; she > of the illness and increases the like- thought that others did as well: she > lihood that when it passes, it will not felt that if she told her fiancé about > recur. Often it is not necessary to take her depression, he would not want her > anti-depressant medications on a con- because she would be "defective mer- > tinuous basis. Anti-depressant med- chandise." And being labeled "a nut > ications are not addictive, and taking case" would ruin her chances of mar- > them allows the body's normal mood riage. "No one would ever want me," > to return. Using medication to fight she said. > depression is only one choice among As Juanita and I talked more, she > many within a person's individualized began to realize that she was not being > wellness plan. The "loony bin" is a honest with herself or with her fiancé. > pejorative term for a mental hospital. She was racing toward marriage, try- > Most people who need treatment for ing to outrun her depression before, in > depression do not need to be hospital- her words, "it took over and ruined my > ized as part of their treatment. Only chances of living a good and normal > if depression goes untreated and gets life forever." > so severe that the person becomes a Juanita's statement is the essence of > danger to himself or herself or oth- stigma—the prejudiced idea that there > ers (like George in the above example) are two groups of people in the world, > might it be necessary to go to a hospi- the "normal" and the "not normal," > tal for a short time. those who have mental illnesses and > Juanita's barriers to treatment in- those who don't. It is an "us vs. them" > cluded not only misinformation about way of thinking in which admitting > her illness, but also all the prejudices mental health problems creates an in- > and false beliefs she had internalized escapable mark of inferiority that sep- > from her family and culture. She ex- arates one from mainstream society. > plained that according to her family, At the beginning of our work to- > people are supposed to "pull them- gether, Juanita could not associate the > selves up by their own bootstraps" idea of "a good, normal life" with "a > and "quit whining and complaining mental illness like depression." It was > and feeling sorry for themselves," and either one or the other. This is not > 72 The Journal of Bahá'í Studies 27.1-2 2017 > > true, but such beliefs have a long his- mental health by creating two separate > tory and are deeply rooted in many insurance systems, one for "medical" > cultures around the world. problems and one for "mental" prob- > lems. The separation permits the allo- > THE HISTORICAL ROOTS OF STIGMA cation of inferior coverage for mental > health treatment and leaves many who > Early Egyptian, Indian, Greek, and need help unable to obtain it. > Roman writings attribute mental ill- > ness to the displeasure of the gods or STIGMA—PREVALENT, > possession by evil spirits. The sufferer POTENT, PERNICIOUS > was blamed for the illness and treated > as a pariah, an outcast deserving ex- Sociologist Erving Goffman is usually > orcism, torture, or even death. This credited with the first systematic ex- > view prevailed despite efforts by Hip- ploration of stigma. In his book Stig- > pocrates around 400 BC to attribute ma: Notes on the Management of Spoiled > mental illness to brain pathology. Identity, he describes it as the social > Throughout the 1800s and early phenomenon of being rejected by a > 1900s, the notion that humane treat- peer group on the basis of an attribute > ment for those with mental health the group finds unacceptable (6–7). > problems would be curative began to Goffman lists three categories of stig- > take hold, but fears and misinforma- matized people: (1) those with "abom- > tion from earlier times remained. Ef- inations of the body"—now known > fective treatments were lacking, and as physical disabilities; (2) those with > those with mental health problems "blemishes of individual character per- > continued to be institutionalized with ceived as weak will," among which he > criminals, the poor, and those with included mental disorders, addiction, > other chronic illnesses. alcoholism, suicide attempts, impris- > From the mid-1900s to the present onment, homosexuality, unemploy- > time, medical experts developed more ment, and radical political behavior; > and better treatments for major de- and (3) those with the "tribal stigma" > pression—most notably, a whole range of race, nationality, and religion (6–7). > of psychotropic medications and ev- The follow-up to Goffman's work over > idence-based psychotherapies. In the succeeding decades became bogged > United States, some efforts were made down with controversies about the > to address mental illness through labeling process itself and whether or > government measures. However, such not it caused stigma. That issue was > initiatives suffered from poor funding never resolved, and as interest in the > and lack of follow-through. topic waned, the notion that stigma > Meanwhile, the American medical was declining took hold. Meanwhile, > insurance industry has been allowed to mental health became a human rights > capitalize on the stigma surrounding issue. > Depression, Stigma, and the Soul 73 > > From the 1970s onward, battles Mental Health reviewed the literature > within the legal system focused on on mental health treatment and found > fair housing, equal employment op- that stigma was "the primary barrier > portunities, and adequate medical and to treatment and recovery" (Office of > psychiatric care for those who need it. the Surgeon General et al. viii). The > The Bazelon Center for Mental Health report notes that the general public > Law3 has been working in this area for still believed Goffman's premise that > many years. An exhaustive treatment mental disorders are the result of > of this topic is outside the scope of "moral failings or limited will power" > this paper, but a few landmark cases (viii) It also over-optimistically pre- > from its website are noteworthy. For dicts that "[w]hen people understand > instance, in the 1970s, Wyatt v. Stick- that mental disorders . . are legitimate > ney established the constitutional right illnesses that are responsive to specific > to treatment for people with mental treatments, much of the negative ste- > disabilities committed to state institu- reotyping may dissipate" (viii). It thus > tions, and O'Connor v. Donaldson estab- calls for mental illness to be defined as > lished the right to freedom from cus- a physical dysfunction, a "disease like > todial confinement for non-dangerous any other" (viii). > persons. The Fair Housing Amend- Following the Surgeon General's > ments Act of 1988 made it illegal to report, what were supposed to be "an- > deny access to housing based on phys- ti-stigma" campaigns were launched > ical or mental disability. In 1990, the to convince people that mental illness > far-reaching Americans with Disabili- was a brain dysfunction. For instance, > ties Act rendered discrimination based in the United States, the National Al- > on mental or physical disability illegal, liance on Mental Illness launched the > just as the Civil Rights Act of 1964 "Campaign to End Discrimination," > had outlawed discrimination based on which emphasized the neurobiological > race, color, religion, sex, or national bases of mental illness and the need > origin ("Our History"). for pharmaceutical treatments. Within > At the turn of the millennium, the following decade, in countries in > when serious attention from the so- North America and around the world, > cial sciences returned to the issue, similar widespread and expensive > the stigma associated with mental campaigns emphasized the brain dis- > illness was found to be prevalent, po- ease model. > tent, and pernicious. In 1999, the first Research indicates that in many > ever Surgeon General's Report on ways, rather than reducing stigma, > these campaigns made it worse. A study > 3 Based in Washington, DC, the Ba- compared data from the 2006 National > zelon Center for Mental Health Law is an Stigma Study-Replication to the 1996 > organization that provides legal advocacy MacArthur Mental Health Study. In > for people with mental disabilities. both studies, the same vignettes were > 74 The Journal of Bahá'í Studies 27.1-2 2017 > > presented to respondents, who were decrease stigma around the world. > asked to imagine themselves interact- Its efforts have been focused on the > ing with a person with a mental health importance of the media in the fight > diagnosis. The report concluded, "No against stigma. Research has shown > significant decrease was reported in that the public perception that people > any indicator of stigma, and levels with mental illnesses are dangerous > remained high" (Pescosolido et al. has been fueled by media reports of > 1324). A majority of the public con- hugely dramatic and destructive acts > tinued to express an unwillingness to of violence committed by a very small > work closely or socialize with persons number of people who are not getting > diagnosed with mental illness or have adequate treatment. While such acts > them marry into their family. And are statistically rare, they powerfully > while believing mental illness to be a create and sustain negative public at- > neurological problem was correlated titudes. The Carter Center has been > working to educate the media about > with believing treatment is necessary, > their responsibility to provide bal- > it was also correlated with believing > anced coverage of the issue of mental > the problem to be irremediable. More > health challenges. It provides schol- > alarmingly, many people in the 2006 > arships to journalists who work on > survey spontaneously volunteered the > projects that emphasize the success > information that they associated men- > of people with these illnesses: the re- > tal illness with an increased risk of > silience, the significant achievements, > violence. and the everyday happy lives of people > in mental health treatment. > THE PERCEPTION OF VIOLENCE RISK In terms of violence risk in the > general population, having a mental > Research has shown that the vast illness can raise the risk of commit- > majority of those with mental illness ting a violent act if the illness is very > are not dangerous. Having a mental severe, causing a break with reality, > illness is not a predictor of violence and if the illness is not being properly > within the general population. In fact, treated. Even then, the increased risk > mentally ill people are more often the of someone committing a violent act > victims of crime than its perpetrators like homicide compared to someone > (Torrey 1–5). in the general population is believed > "But," you might ask, "what about to be "about 2% or less" (Torrey 1). > all the media reports on mass shoot- However, the criminal justice system > ings? Aren't all these committed by has amassed a large number of cases > mentally ill people?" The answer is involving these severely ill individuals > complicated. because the lack of available psychiat- > For many years, the Carter Center ric hospitals has left many homeless > in Atlanta, Georgia, has worked to and without treatment or sufficient > increase mental health treatment and resources to survive. > Depression, Stigma, and the Soul 75 > > THE DEVELOPMENT OF SELF-STIGMA the prejudices against those with men- > tal health problems become reflected in > Social psychologist Patrick Corrigan the government and community infra- > is one of the most well-known experts structures. The ongoing legal battles > in the field of mental health stigma.4 and biases in the healthcare delivery > He explains that it is important to ac- system discussed above are examples > knowledge that stigma is not a figment of structural stigma. Self-stigma oc- > of the imagination of those who suffer curs when the prejudicial attitudes of > from these illnesses. "The problem of the public sector are co-opted by indi- > stigma," he and mental health services viduals with mental health challenges > researcher Nev Jones write, "does like depression. > not lie within the individual with the As Corrigan, Jonathan E. Larson, > mark, but rather in the stigmatizing and Nicolas Rüsch explain, self-stig- > communities in which the individuals ma develops through three separate > find themselves" (Jones and Corrigan but related processes: stereotyping, > 9). Corrigan's work shows that nega- prejudice, and discrimination (75). The > tive community attitudes (public stig- first component, stereotyping, can be > ma) can be internalized by the sufferer relatively benign. Webster's Dictionary > and become "self-stigma." The story defines stereotyping as a process of > of Juanita is a good example; her sto- unfairly believing "that all people or > ry shows how internalized prejudicial things with a particular characteristic > beliefs distorted her thinking and pre- are the same" ("Stereotype"). Social > sented a major barrier to her seeking groups share stereotypes as part of > treatment. their common culture, and these as- > Corrigan, Benjamin G. Druss, and sumptions are often reinforced in the > Deborah A. Perlick distinguish be- arts and media. It is easy to think of > tween three main types of stigma: some of them: "the suit," a conserva- > public, structural, and self-stigma. tive banker who dresses impeccably; > Public stigma refers to the attitudes "the class clown," a middle-school boy > of the general public that are outlined who is disruptive but funny; "the soc- > above. Structural stigma occurs when cer mom" with her minivan and work- > out gear. > 4 Corrigan identifies himself as a Corrigan, Larson, and Rüsch con- > survivor, researcher, and advocate. His tend that while stereotyping itself is > website (http://www.stigmaandempow- somewhat inevitable and not neces- > erment.org/) provides tools and resourc- sarily damaging, it can be dangerous > es to empower those with mental health when it opens the door to the second > challenges. Recently, he was appointed ed- and third aspects of the stigmatization > itor in chief of Stigma and Health, a newly process, prejudice and discrimination. > created journal of the American Psycho- When stereotypes become fixed neg- > logical Association. ative beliefs about a group, they are > 76 The Journal of Bahá'í Studies 27.1-2 2017 > > called "prejudices." When large seg- himself it was a just a joke. But the > ments of society begin to share those label stuck, and as time went on, he > prejudices and act upon them, discrim- began to adopt it, even introducing > ination is the result (81). himself to other people as "the new > It is important to understand how geek in tech support." > this counterintuitive and often uncon- The day before the party, Carl be- > scious process of self-stigmatization gan to imagine himself being there. > works because self-stigma can com- He thought, "I am a bit shy and seri- > bine with the symptoms of depression ous. I wear T-shirts and a hoodie all > to create a sense of hopelessness and the time. Sometimes when people tell > treatment avoidance that can lead to a joke, I don't get it." In his mind's > suicide. Corrigan, Larson, and Rüsch eye, he imagined himself as "the geek" > call this the "why try" effect (75). sitting alone at the party, feeling sad > In the following hypothetical ex- and ashamed because he doesn't fit in, > ample, Carl will self-stereotype him- so he eventually decided not to go. On > self as a "geek" and stereotype his co- Monday morning, a coworker said to > workers as "artsy types." Then, based him, "Hey Carl, we missed you last > on these prejudices, he will imagine a Saturday night! What were you do- > sequence of events that will lead him ing?" Carl looked down at the floor > to discriminate against himself. and mumbled, "I played video games" > Carl, is a gifted programmer who as he walked away. The coworker, feel- > moved from a San Francisco technical ing snubbed, thought, "I guess you re- > firm to a New York City advertising ally are a nerd." > and media firm. Six months into his Carl's self-stigma blocked his view > new job, the creative arts department of reality. He didn't know that when > staff invited him to a party. He wanted his coworkers met him, they immedi- > to go because he felt lonely. He had ately liked him. They were fans of the > been having difficulty making friends television show The Big Bang Theory, > in New York. In California, he and in which a "nerd" hero creates comedy > his friends had hiked together on out of his extreme intelligence and > weekends and played video games at lack of social skills. Carl's coworkers > lunch. These New York "urban artsy were comparing him to their hero > types," as he called his coworkers, when they used that label. For them > didn't share his interests in computers it was a benign stereotype. But Carl > and the outdoors. He began to notice didn't know that. Instead of going to > that they often referred to him as "our the party and testing his theory of > new geek" or, sometimes, "the nerd." being an outcast, he stigmatized him- > He had never been called that before self and stayed home, thereby effec- > and wasn't sure how to react. tively creating the reality of being an > At first Carl tried to convince outcast through his own actions. > Depression, Stigma, and the Soul 77 > > LABEL AVOIDANCE AND THE This is the reality for people with > "WHY TRY" EFFECT major depression. They are squeezed > between the pain of their own illness > The self-stigma that kept Juanita from and the scourge of public opinion, > getting mental health treatment is in forced to choose between the rages of > some ways similar to Carl's self-stig- their own internal suffering and the > ma. Juanita labeled a depressed per- loss of their sustaining ties. And as a > son like herself "a nut case" and saw society, we are asking them to face this > herself as "less than" someone who unsolvable dilemma at the very time > does not need mental health treatment they feel most vulnerable and least > (prejudice). She then acted on her be- able to cope, at a time when all the > liefs when she avoided treatment (dis- symptoms described at the beginning > crimination). Juanita was engaging in of this article are in full force. Is it > what Jones and Corrigan call "label any wonder that many find themselves > avoidance," which he defines as "re- boxed into a no-win, no-way-out co- > fusing to get help for mental illness in nundrum that leads many to feel death > order to avoid the label of being men- is the only solution? > tally ill" (19). > However, Juanita's self-stigmati- MIND, SOUL, AND RELATIONSHIPS > zation is different from Carl's in two > important ways: first, Carl was sim- The above discussion reflects the com- > ply feeling a bit sad about missing his plexity of depression and stigma. De- > friends, but Juanita was suffering from pression and other mental illnesses are > a serious mental illness, major depres- private, and they are public. They are > sion; second, while Carl's coworkers widespread throughout the world yet > actually liked him, a large portion of uniquely expressed within each indi- > the general public holds negative views vidual. They are embedded in relation- > about people with mental health issues. ships yet deeply personal and intra- > Juanita had to choose between get- psychic. Genetics play a roll, but they > ting treatment and potentially losing only partially explain the complex, > the supportive network of her fiancé, life-threatening challenges of depres- > friends, and family, and refusing treat- sion and other major mental illnesses. > ment to keep her social network. Can Decades of research and public cam- > she be blamed for choosing to main- paigns have failed to eradicate stigma, > tain her relationships? Is it fair to ask and the widespread phenomenon of > a person suffering from feelings of untreated mental illness goes on. In > hopelessness and self-loathing to fight fact, the problem seems to be getting > public opinion that decades of social worse. What can be done? > science research, public relations, and The soul is a timeless concept. > government programs have failed to Bahá'ís believe in the soul, as do the > impact? followers of most of the world's > 78 The Journal of Bahá'í Studies 27.1-2 2017 > > major religions dating back to ancient as machines whose separate parts add > times. Aristotle, Socrates, and many up to the whole. The example of a bro- > other ancient philosophers spoke of ken clock is often used as an example. > the soul. Indigenous and Native peo- If the clock isn't working, take apart > ples also affirm the existence of our the pieces one by one, find the broken > link to the Great Spirit that provides piece, fix it, then put the clock back to- > guidance during this lifetime and the gether. According to this logic, if the > next. problem is depression, label the de- > However, introducing the con- pressed group "not normal," separate > cept of a "soul" into a discussion of it from the "normal" group, analyze > problems that have variously been the parts that appear to be "broken"— > defined as the province of medicine, concrete, physical, measurable things, > psychiatry, sociology, law, and public such as chemical imbalances—then fix > health may seem incongruous, even those with equally concrete, physical, > contrived. But consider for a moment: measurable things like medications. > perhaps the intractability of stigma is Notice the actions involved in this > related to the framework within which approach that contribute to stigma: la- > it has been addressed. Perhaps the ap- beling, separating, defining as broken, > proaches reviewed above contributed assuming an outside expert is needed > to stigma by labeling and categorizing to fix the brokenness, and ignoring > human beings rather than seeing them all the unquantifiable aspects such > as unique, complex, multifaceted, and as social relationships, inner psychic > transcendent. Perhaps when dimen- thought processes, spirit, and soul. > sions like wholeness, interconnection, Although slightly exaggerated for the > soul, and spirit are eliminated and re- sake of making the point, this is essen- > placed with static categories and nega- tially the biomedical model of health. > tive labels, stigma is the result. It prides itself on being hard science > Starting with the Enlightenment, because it shows cause and effect as > Western research and practice in most linear, fixed, and measurable. Within > fields of science removed any con- this model, there is no room for the > siderations of the spiritual nature of least measurable, least quantifiable, > mankind. As technology and science most ineffable aspect of a human be- > rapidly advanced, the dominant para- ing, the soul. Could it be that without a > digm became materialistic and mecha- framework that includes the transcen- > nistic. From this perspective, the only dent, the problem of stigma and the > things that exist are those that can be puzzle of recovery from mental health > observed and measured. That is why issues cannot be solved? > the doctor in the emergency room told Daniel Siegel is a clinical professor > George his problems were not real af- of psychiatry at the UCLA School of > ter his lab tests proved to be negative. Medicine and the founding co-director > Mechanistic ideologies see humans of the Mindful Awareness Research > Depression, Stigma, and the Soul 79 > > Center at UCLA. In his popular work the relational aspect of individuals > Mindsight, he tells the story of his and the theory, skills, and benefits of > own struggle with trying to help peo- personal growth and changes in states > ple within the boundaries imposed by of mind. He suggests that through > the medical model. It nearly drove him self-awareness we can become mindful > out of the field. He took time off from of our own internal subjective states > his training, and when he returned, and how these directly shape our phys- > he was determined to take a differ- iological and psychological health. He > ent stance. The result is his lifework, explains that through this awareness, > called "interpersonal neurobiology," we can change the organization and > which is taught through his books, structure of our own brains. He calls > lectures, and the Mind Sight Institute this awareness "mindsight" and de- > (www.mindsightinstitute.com). scribes it as a process that "enable[s] > Mindsight begins with the question, us to sense and shape energy and in- > "What is the mind?" A basic question, formation flow" (55). Higher states of > it would seem, in a field named "men- consciousness lead to transcendence, > tal health." But, he says, no one really in which people simultaneously see > knows. He polled over eighty thousand themselves as unique individuals and > experts about whether or not they part of the entirety of humanity, the > had ever attended a course or lecture whole of creation (52). "Mindsight," > defining the mind or mental health: Siegel explains, "takes away the su- > "The responses were easy to count. In perficial boundaries that separate us > numerous countries on four different and enables us to see that we are each > continents, in lecture halls around our part of an interconnected flow, a wid- > globe, the same statistic has emerged er whole. By viewing mind, brain, and > again and again: Only 2 to 5 percent of relationships as fundamentally three > people in this field had ever been given dimensions of one reality—of aspects > even a single lecture that defined the of energy and information flow—we > very foundation of their specialty— see our human experience with truly > the mind" (51). Siegel set out to do new eyes" (58). > just that, and his work is noteworthy He emphasizes that self-reflection is > in many ways. at the heart of mindsight. He reports > In Siegel's model, the mind is not a that when people become more inter- > material thing but rather an integral nally integrated and insightful about > part of the interplay among three as- themselves, "[t]heir identity expands; > pects within what he calls the "trian- they become aware that they are part > gle of well-being"—mind, brain, and of a much larger whole. In various re- > relationships. "The mind," he says, "is search explorations of happiness and > a relational and embodied process that wisdom, this sense of interconnection > regulates the flow of energy and in- seems to be at the heart of living a life > formation" (11). His model emphasizes of meaning and purpose" (76). > 80 The Journal of Bahá'í Studies 27.1-2 2017 > > Siegel's definition of mental health and effects" (55:5), just as Siegel as- > is "integration." He says, "With in- serts that "mindsight" allows one to > tegration, we see ourselves with an monitor and modify the flow of in- > expanded identity. When we embrace formation internally. Siegel says that > the reality of this interconnection, the mind cannot be separated from > being considerate and concerned with relationships with others. The pro- > the larger world becomes a fundamen- cess of the soul is concerned with > tal shift in our way of living" (260). relationships too, with "the qualities > Siegel uses brain science to argue that and properties of beings" (55:5). Both > the "mind" can change the brain and definitions emphasize growth, discov- > therefore behavior. "The mind uses the ery, and the acquisition of knowledge. > brain to create itself," he says (261). Both affirm a human spirit that con- > Compare this description of the in- nects us all together in an integrative > tegrated mind with 'Abdu'l-Bahá's de- whole. Both allow for complexity and > scription of the rational soul in Some connections among seemingly dispa- > Answered Questions: rate parts. 'Abdu'l-Bahá states, "Reflect > upon the inner realities of the uni- > The human spirit which distin- verse, the secret wisdoms involved, the > guishes man from the animal is enigmas, the inter-relationships, the > the rational soul, and these two rules that govern all. For every part of > names—the human spirit and the universe is connected with every > the rational soul—designate one other part by ties that are very power- > thing. This spirit, which in the ful and admit of no imbalance, nor any > terminology of the philosophers slackening whatever" (Selections 137). > is the rational soul, embraces all Furthermore, in The Promulgation of > beings, and as far as human ability Universal Peace, 'Abdu'l-Bahá declares, > permits discovers the realities of "Religion must conform to science and > things and becomes cognizant of reason; otherwise, it is superstition. > their peculiarities and effects, and God has created man in order that he > of the qualities and properties of may perceive the verity of existence > beings. (55:5) and endowed him with mind or reason > to discover truth. Therefore, scientific > While Siegel's definition of the knowledge and religious belief must > mind and 'Abdu'l-Bahá's definition of be conformable to the analysis of this > the soul are not completely identical, divine faculty in man" (96). > they are compatible. The soul as de- The preceding discussion shows > scribed here is dynamic, a process and that love is good science and that the > not a static or material "thing." It "dis- powerful reality of the human soul and > covers the realities of things" (55:5). spirit defines human beings regardless > The soul includes understanding and of the barriers that may at times dim > gaining insight about "peculiarities their lights. > Depression, Stigma, and the Soul 81 > > "CONSIDER THE LIGHT OF THE LAMP" of soul. Let us hope in the mean- > time scientists will find better and > That movement toward the spiritual permanent cures for the mentally > and transcendent is necessary to ad- afflicted. But in this world such > dress mental health was also affirmed illness is truly a heavy burden to > by Shoghi Effendi in a letter to an in- bear! (qtd. in Selections from Bahá'í > dividual believer dated 12 April 1948. Writings 948) > He reflects: > In this letter, Shoghi Effendi cele- > It is very hard to be subject to any brates the power of the soul, empha- > illness, particularly a mental one. sizes its inherent health, and describes > However, we must always remem- illness as a "hindrance" between the > ber these illnesses have nothing soul and the body, a point also under- > to do with our spirit or our inner scored by Bahá'u'lláh: > relation to God. It is a great pity > that as yet so little is really known Know thou that the soul of man is > of the mind, its workings and the exalted above, and is independent > illnesses that afflict it; no doubt, of all infirmities of body or mind. > as the world becomes more spir- That a sick person showeth signs > itually minded and scientists un- of weakness is due to the hin- > derstand the true nature of man, drances that interpose themselves > more humane and permanent between his soul and his body, for > cures for mental diseases will be the soul itself remaineth unaffect- > found. The Guardian, much as ed by any bodily ailments. Consid- > his heart goes out to you in your er the light of the lamp. Though > fear and suffering, cannot tell you an external object may interfere > whether electric shock treatments with its radiance, the light itself > should or should not be used, as continueth to shine with undimin- > this is a purely medical question, ished power. In like manner, every > and there is no reference to such malady afflicting the body of man > details in our Scriptures. The best is an impediment that preventeth > scientists must pass upon such the soul from manifesting its in- > methods, not laymen. You must herent might and power. (Glean- > always remember, no matter how ings 153) > much you or your others may be > afflicted with mental troubles Siegel's work suggests that when a > and the crushing environment of person is experiencing maladies that > these state institutions, that your affect the mind, relationships, or "soul > spirit is healthy, near to our Be- to soul" connections, can wield a pow- > loved, and will in the next world erful force. Within loving relation- > enjoy a happy and normal state ships, the positive energy flow helps > 82 The Journal of Bahá'í Studies 27.1-2 2017 > > buttress those who are experiencing of detachment may be made man- > mental health challenges. Converse- ifest. Such is My counsel to you, > ly, stigma and related negativity like O concourse of light! Heed ye > judgment, criticism, or relationship this counsel that ye may obtain > "cut-off " can cause irreparable dam- the fruit of holiness from the tree > age. The Bahá'í community, with its of wondrous glory. (Bahá'u'lláh, > emphasis on love, community building, Hidden Words, Persian no. 69) > and reliance on the spirit, is uniquely > suited to respond to the needs of those The Bahá'í Writings are very ex- > who suffer from mental illness. plicit in regard to what a relationship > would look like when walking "even as > ACCOMPANIMENT AND RECOVERY one soul." This beautiful and moving > passage sets a new standard of friend- > Accompaniment is a concept that has ship for all of us. 'Abdu'l-Bahá says > recently become a lodestone of com- that > munity building efforts within the > Bahá'í Faith. To accompany someone the Cause of the Ancient Beauty > is to stand next to that person and "be is the very essence of love, the > there," supporting him or her with very channel of oneness, exist- > understanding and empathy. Accom- ing only that all may become > paniment is neither giving advice nor the waves of one sea, and bright > abandonment. It is non-judgmental stars of the same endless sky, > supportive friendship, a soul-to-soul and pearls within the shell of > relationship in which each learns from singleness, and gleaming jewels > the other. quarried from the mines of unity; > that they may become servants > O children of men! Know one to another, adore one another, > ye not why We created you all bless one another, praise one an- > from the same dust? That no one other; that each one may loose his > should exalt himself over the tongue and extol the rest without > other. Ponder at all times in your exception, each one voice his grat- > hearts how ye were created. Since itude to all the rest; that all should > We have created you all from one lift up their eyes to the horizon of > same substance it is incumbent on glory, and remember that they are > you to be even as one soul, to walk linked to the Holy Threshold; that > with the same feet, eat with the they should see nothing but good > same mouth and dwell in the same in one another, hear nothing but > land, that from your inmost being, praise of one another, and speak > by your deeds and actions, the no word of one another save only > signs of oneness and the essence to praise. (Selections 193) > Depression, Stigma, and the Soul 83 > > 'Abdu'l-Bahá has given a clear answer (SAMHSA) is a large government > to the question, "How do you accom- organization in the United States that > pany a person with mental health oversees a variety of mental health > challenges?" Extol without exception. programs, research efforts, and poli- > Serve, bless, praise; see the good only. cy recommendations. Recently, it re- > Express gratitude and love, even to leased a new set of policy guidelines > the point of "adoring" one another. regarding mental health treatment > If you are the one who is depressed that rejects the old medical model and > or suffering from another mental embraces an individualized, self-deter- > health challenge, you may find it help- mined, holistic approach. Recovery is > ful to substitute "one another" in the defined as a process that encompasses > passage above with the word "your- > an individual's whole life "including > self " as you progress toward achiev- > mind, body, spirit, and community" > ing recovery. In spite of the veil you > ("Recovery"). The guidelines state > may feel between your conscious self > that "there are many different path- > and your spirit, strive to love yourself, > ways to recovery and each individual > praise yourself, see the good in your- > self, and be grateful to yourself for determines his or her own way" (del > bearing up under your heavy burden. Vecchio). > Try not to put yourself down, even Recovery is defined as "a process > though depression may be twisting of change through which individuals > your thoughts to the negative. Be kind improve their health and wellness, live > to yourself. And at the same time, real- a self-directed life, and strive to reach > ize that it is no one's problem to solve their full potential" ("Recovery"). The > but yours. That means recovery from guidelines emphasize that recovery is > major depression and other mental ill- real. No matter how severe and long- > nesses may be more or less a full-time standing a mental illness may be, it is > job, and it may be one you will do for possible to create a plan that allows > the rest of your life. for a full and meaningful life. By tak- > Taking responsibility for the ill- ing charge of one's own illness and > ness is step number one. This does assembling medical help, counseling, > not mean believing that you caused skill training, nutrition, exercise, > the problem or that it is your fault. mind-body practices like yoga and > It means understanding and valuing meditation, and other curative prac- > your uniqueness while realizing that tices, individuals become healthy and > only you can create the recovery plan empowered. > that will be right for you. Of course, various situations can > make recovery more complex. A his- > RECOVERY tory of physical and/or psychological > trauma requires specialized trauma-fo- > The Substance Abuse and Men- cused services by persons with train- > tal Health Services Administration ing in these areas. A trauma history > 84 The Journal of Bahá'í Studies 27.1-2 2017 > > can greatly complicate the already mid-thirties whom I met at a Bahá'í > complex issue of recovery. Likewise, conference on healing. She was a > when addictive behaviors are part of speaker who shared her recovery plan > the picture, they too require special- with the group. Despite having been > ized treatment. Self-help groups aid diagnosed with major depression, > recovery and emphasize that personal anxiety with panic attacks, eating > change is a life-long process of discov- disorders, and borderline personality > ery that benefits from group support. disorder, she reported that she is liv- > The recovery process is ever chang- ing a full and meaningful life. Samila > ing and may include setbacks and has created a comprehensive array of > learning experiences that are painful. resources and practices that she calls > This is normal and should not be asso- her "wellness plan." It includes regular > ciated with failure or lack of effort or visits with a psychiatrist, psychother- > willpower. Setbacks are opportunities apist, and registered dietitian; physical > for growth. Small initial steps are of- exercise; interpersonal skill training > ten the most difficult, and when they using Dialectical Behavior Therapy; > do not result in the immediate allevi- an active spiritual life; and participa- > ation of symptoms, many individuals tion in Bahá'í community activities. > lose hope and stop the process. It is Samila created the plan herself. She > important not to give up but to con- explained, "We have to find the way > tinue forward, adding more pieces to ourselves because no one else is going > the recovery plan until the symptoms to do it for us." > are under control and life is livable. Samila agreed to share her story > The new guidelines highlight that during a telephone conversation in > recovery is a way of life and the "ex- August 2016: > perts" are those with the "lived experi- > ence" of healing. In the following sto- You are already fighting a bat- > ry, Samila suffers from major mental tle every single day against your > illnesses and stigma. When her inter- own brain, but it's worse to fight > nal distress becomes too much to bear, the stigma that you have put on > she is faced with a choice. Her story yourself and that other people > shows how the supportive respons- have put on you. I just remember > es of others in her life enabled her the years and years I went with- > to survive and begin her journey of out help because I was so afraid > healing while discovering the spiritual of being seen as damaged. I hid > purpose of her life. it. I didn't get the help I needed. > I beat myself up for decades and > WAVES OF ACCEPTANCE just hurt myself so much mental- > ly and emotionally. Those were > Samila (whose name has been changed circumstances that were largely > for anonymity) is a woman in her set up for me by my parents, but > Depression, Stigma, and the Soul 85 > > that was the only attitude they had terrifying. My mom sat by me and > ever known. You didn't talk about hugged me and cried and was just > it. You certainly didn't acknowl- there for me. > edge it. You moved forward. You It is three years now that I have > distracted yourself. You just con- been talking about my mental > tinued on as if nothing is really health. I am owning my mental > wrong. You can't say, "Something illness and talking openly about > is wrong" because it's not your it. I still get scared, but now it's > foot that hurts. It's your brain my way of saving myself. > that hurts. People can't fathom I used to say, "Why did I get this > that. It is a scary unknown beast. as my lot in life?" And the answer > Everybody goes silent when you I got back from God was, "This is > talk about it. your purpose. You have been giv- > For over thirty years I lived en this challenge so you could use > with shame and fear and felt an- it for some good." If I talk about > gry and bitter because these were this, maybe it will at least reduce > the circumstances I was given. I some of the stigma, at least in my > thought, 'Why did I have to get corner of the world. > this kind of life?' Now I go toward the love— > When I had my breakdown a those who reach out to me and > few years ago, it was the first time say either, "I struggle too," or > I contemplated suicide. I realized they say, "I think you are so great > the things I was doing in my life and courageous," and others say, > made it impossible to live. I could "I want to be there for people like > not continue playing this game I you too." Whatever makes me feel > had not signed up for. There were seen and heard gives me hope, as > rules that had been imposed upon the waves of acceptance flow out. > me, and I had no choice in them. I > realized hey, if these are the rules > and they mean I can't live any- CONCLUSION > more, I can't survive. I was never > hospitalized. I was in my office at The goal of the preceding discussion > work when I had this realization. has been to show that the application > Later that day I was able to see of the Bahá'í teaching of the unity > my therapist. She made me sign of mankind is urgently needed in the > a contract that I would not take field of mental health. > my own life. I promised I'd go Depression is now the leading cause > and stay with my parents and tell of disability worldwide and despite > them the truth. That was the first the fact that highly effective treat- > time I ever told my parents I had ments are available, the majority of > these kinds of thoughts. It was those who suffer do not get the help > 86 The Journal of Bahá'í Studies 27.1-2 2017 > > they need. The stigma of mental ill- As the many stories and examples > ness is the greatest barrier to treat- illustrated, depression expresses itself > ment. Stigma is a societal problem; a uniquely within individuals and each > problem of attitude, of ignorance, and healing journey is different. But all hu- > denial. It labels and blames those who man beings benefit when the reality of > suffer and greatly enhances their dis- the soul and the potency of supportive > tress at the time when they most need relationships are acknowledged. In- > love and support. It creates societal terpersonal neurobiology shows how > barriers that go unchallenged despite the mind depends on relationships for > their glaring inequities and negative health and how transcendence itself is > consequences. linked to the reality of love as it un- > Conversely, when communities rec- folds within each of our lives. Healthy > ognize and welcome those who have individuals have a responsibility to > mental health challenges like depres- examine their attitudes about mental > sion, they begin to create the frame- health challenges, educate themselves, > work within which the sufferers can and take an active role in combating > heal while the community benefits stigma through loving compassion to- > from their presence. wards those who suffer. > > WORKS CITED > > 'Abdu'l-Bahá. The Promulgation of Universal Peace. 2nd ed., US Bahá'í Publishing > Trust, 1982. > ———. Selections from the Writings of 'Abdu'l-Bahá. 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