The Hidden Toll of Shame on Mental Health

Understanding Shame and Its Impact on Mental Health

Shame- a painful emotion that can have serious consequences on mental health, often hiding beneath the surface through our daily lives. Many people are unaware of how intense self-criticism (arising from shame) can propel harmful behaviors, prevent personal growth, fuel mental health difficulties and symptoms of mental illness. While everyone experiences shame to some degree, when it becomes intense or longstanding, it can negatively impact one’s self-esteem, sense of worth, and ability to connect with others. I have noticed through work with many of my clients, that shame is often not noticed or acknowledged enough to be worked on.

Shame versus Guilt

As many people often confuse the terms shame and guilt, it is crucial to distinguish between them, as understanding this difference can change how we view and manage ourselves. Guilt refers to feeling bad about a specific behavior or action, suggesting a need for us to make amends. For example, feeling guilty after hurting a friend encourages us to repair the relationship. Guilt is often a constructive response that supports personal growth and accountability.

Shame, on the other hand, is more deeply internalized and harder to notice as my experiences as a therapist have shown. Instead of focusing on actions, shame targets the self- leading people to feel they are inherently flawed or unworthy. This is often without any particular actions to cause it. For example, rather than thinking, "I made a mistake," a person might think, "I am a failure." This internalized belief can be paralyzing, trapping individuals in a cycle of self-blame and self-criticism that damages self-esteem and increases vulnerability to anxiety, depression, and other mental health conditions.

How Shame Fuels Mental Health Stigma

One of shame’s most destructive impacts on mental health is its role in perpetuating stigma. Shame fuels a narrative to people that they are “weak,” “helpless” or “unworthy” if they struggle with their mental health or need help.

These feelings can often prevent individuals from seeking support or opening up to others, leaving them isolated due to their shame. Sometimes a person who feels such deep shame will believe that they are not worth fixing and are deserving of their distress- preventing them from seeking out therapy. In South Africa, where mental health stigma remains a barrier to accessing treatment, shame often convinces people they should handle problems on their own. Shame also makes a person feel like a burden to others, even their psychologist in some cases as I have seen with clients! This, similarly, leads to an avoidance of treatment.

Unfortunately, avoiding treatment due to shame can worsen symptoms, creating a cycle in which individuals experience greater isolation and suffering. By addressing shame and reducing stigma, we encourage people to reach out for the support they need, which is crucial for mental health and well-being. Shame is crucial to confront and deal with so that quality mental health can be achieved.

The Effects of Shame on Mental Health

Unresolved shame can severely impact mental health, leading to several harmful consequences:

1. Increased Anxiety and Depression:

Shame can exacerbate symptoms of anxiety and despair, making individuals feel as if they are “never good enough.” This can include feelings of hopelessness, helplessness, overwhelm, low self-esteem, suicidal thoughts/actions and anhedonia (loss of interest, pleasure and motivation). The worse these symptoms become, the louder the voice of shame becomes creating a self-destructive loop leading to a severe mental downward spiral.

2. Social Withdrawal:

Shame often leads people to avoid social interactions out of fear of judgment or rejection. In many cases with my own clients, the person comes to believe that everyone else shares their feelings of themselves i.e. others similarly shame me as much as I shame myself. They come to believe their shame is based on a reality that everyone can see. This isolation can deepen feelings of loneliness and make it harder to build or maintain supportive relationships.

It further isolates people with mental distress who feel such shame in that they feel “unworthy” of their loved ones. This isolation keeps a person in their own echo-chamber with exceptionally negative thoughts. This creates a snowball effect for mental distress.

3. Low Self-Esteem:

People struggling with chronic shame often internalize negative beliefs about themselves, which damages their self-worth. Low self-esteem can affect relationships, work, and general well-being; contributing to a cycle of self-doubt and self-sabotage. A client who believes that they are that worthless interacts with others in a specific way. These interactions evoke responses from others that reinforces the client’s incorrect beliefs about themselves. The client, in experiencing shame, creates self-fulfilling prophecies. They may misread social cues and incorrectly interpret actions as people sharing their negative view of themselves. Our perspectives of ourselves greatly shapes the way we believe others see us. A person experiencing shame believes others see their worthlessness.

4. Inhibition and Self-Sabotage:

Shame can cause people to hold back from pursuing their goals, fearing failure or rejection. This avoidance can lead to a sense of unfulfillment, which reinforces negative beliefs about one’s abilities or worth. A person who expects to be rejected due to their feelings of worthlessness, will be likely to incorrectly interpret others’ behaviours as rejecting.

Moving from Shame to Self-Acceptance: How to Break the Cycle

Awareness is a powerful first step in addressing shame and its impact on mental health. Here are some ways to begin shifting from shame to self-acceptance:

Practice Self-Compassion:

Self-compassion means treating yourself with the same kindness you would offer to a friend. Rather than criticizing yourself, aim to show empathy. Seek an understanding that everyone makes mistakes and has flaws. Self-compassion helps to soften the harsh self-criticism that comes from shame. A great exercise I use in my practice is asking yourself: “How would I help a child who was experiencing the same shame and self-criticism I am experiencing?” Then apply that approach to yourself.

Recognize and Challenge Negative Thoughts:

Shame is often fueled by negative thought patterns that reinforce feelings of inadequacy. Challenging these beliefs daily can help reduce their power over you.

Seek Support:

Talking about shame with a therapist or support group can break down its isolating effects. Therapy can help unpack the origins of shame and create pathways toward healing. Even just talking to a friend or loved one sometimes can assist you to see the contrast in your view of yourself versus how others actually see you.

Replace Shame with Constructive Guilt:

Where possible, work to shift shame-based self-perceptions to more constructive guilt, which allows you to acknowledge mistakes without defining yourself by them. Ask yourself if you are feeling guilty for something you did or did not do? If so, what can you do to try rectify it? Attempt to rectify it until you can do no more. Now, each time that shame comes up, remind yourself actively that you have done the best you can and try release yourself from this shame.

Journal or Make an External Reminder

Write to yourself as if you are a sad child that you are trying to help. Release the feelings of shame into words when you feel down and assess them for reality. Or, write some positive things about yourself when you are in a better mood to be able to read it when you are in a bad space. Often, just seeing these things written down is a large release of the emotional burden we carry.

Alternatively, make a collage of pictures of your happiest memories or achievements or write out lists of all your achievements and strengths in your life. Put this in an area where you will see it often (such as your bedroom) so that it acts as a reminder than your shameful feelings are not based on reality but rather are just a distorted perspective.

Overcoming Shame Together

Understanding the difference between shame and guilt can help people recognize when they are being unreasonably hard on themselves, rather than engaging in healthy self-reflection. By addressing and reducing shame, we can encourage a culture where mental health struggles are met with understanding rather than judgment.

If you or someone you know feels held back by shame, support is available. I have assisted many clients with these issues at Brandon Kayat Psychology. I offer a range of therapy options to address shame, self-criticism, and stigmas of mental health.

Remember, seeking help is a step toward breaking the cycle of shame and embracing a life defined by self-acceptance and growth. Even though you may not feel it, you do deserve this.