What Happens When Nobody Talks About Mental Illness?

How many more self-inflicted deaths will it take to finally destigmatize mental illness in this country?

As illustrated in a popular Ted-Ed Talk, 10 percent of American adults struggle with depression. Focusing our attention exclusively on outward manifestations of depression and mental illness, one of the most extreme examples being suicide, means we’re missing the point.

Why do so many of us suffer from depression in the first place?


mental illness

Depression has no single identifying marker, but instead is diagnosed by the presence of an array of symptoms, including:

  • Insomnia
  • Loss of interest in activities
  • Change in appetite
  • Chronic anxiety
  • Low self-worth

A lack of your Sense of Self (SoS) signals the presence of a Substitute Sense of Self, which similarly to depression, manifests with diverse and unrelated symptoms: lethargy, low self-esteem, addiction to approval, aimlessness, or perfectionism in one’s personal or professional life.

The similarities between depression and living with a Substitute Sense of Self (SSoS) are striking.

We’re not in the middle of a suicide epidemic—we’re in the middle of an ongoing mental illness crisis.

School shootings, the opioid epidemic, the ongoing failure of the healthcare system to provide sustainable support for those who suffer from mental illness, or all the evidence (suicide was the tenth leading cause of death among Americans in 2016) has elicited reactions of shock and disbelief that are clearly out of touch with reality.

Why the disconnect, people?

The Experience of Depression

Maybe it’s because depression is so hard to pin down, both for those who suffer from it and those who observe it from the outside. Depression manifests differently from individual to individual and is an internalizing disorder, which means the struggle can go on for years without producing easily observable signs of someone’s emotional pain.

And for those who do suffer from deep-seated depression, the challenge of articulating the experience to people who have never suffered from depression can be insurmountable. In addition, mental illness is so stigmatized that people may wait years to talk about their internal struggle to anyone—if they ever do.

One of the most vivid and visceral accounts of depression is William Styron’s 1990 memoir Darkness Visible. Styron writes:

The gray drizzle of horror induced by depression on the quality of a physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair […] comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room.

Your Sense of Self and Your Mental Health

Difficulties in describing the experience of the disease aside, the question remains: why do so many of us suffer from depression? We believe a possible answer may lie in missed opportunities to develop a natural Sense of Self early on in life.

When you live with a SubSoS you make decisions based on what will gain you the approval and acceptance of others, whether that be parents, partner, your boss, or anyone else. You experience the absence of affirmation from others as a threat to your very existence. As a result, your actions, decisions, and your day-to-day life may not align with the real goals you have for your authentic Self.

Also known as a fear of annihilation, this addiction to approval has its roots in the relationship you had as a child with your primary caregiver. When you live through childhood emotional neglect, you don’t have an opportunity to honestly find out who you truly are, as you spend your time and energy trying to figure out how to be and what to do to get the affirmation you crave.

This approval-seeking/approval-withholding dynamic is usually instigated unconsciously by a parent or caregiver due to their lack of emotional intelligence. Unhealthy early relationships with their own caregivers are often the source.

Childhood emotional neglect constitutes a very specific type of trauma with the potential for significant fallout later in life, including the inability to form healthy, supportive relationships as an adult.

Not all people who suffer from depression experienced childhood emotional neglect, and not all people who suffer emotional trauma will develop clinical depression. The causes of depression are multivalent: genetic, chemical, and environmental.

We would be remiss to claim a correlative link between a Lack of Sense of Self and depression or any other mental illness. But given the devastating emotional and physical repercussions of living with a Substitute Sense of Self, could it not be hypothesized that deep-seated depression is an advanced stage on a path of trauma that began early in life?

Restore Your Natural Sense of Self

The path away from an SSoS and a lifetime of emotional pain unfolds when you begin to restore your Sense of Self. When you take the time to get to know your real abilities, your weaknesses, and your true purpose, you reclaim the power you need to start living life as the independent and authentic person you are.

As a result, you’ll elevate your self-worth, develop your emotional intelligence, and enjoy healthier, more fulfilling relationships with your loved ones. The isolation and confusion you’ve struggled with will be replaced by a new clarity and focus in your everyday life.

Prioritize your true happiness and take the first step towards a Restored Sense of Self. Check out our free eBook, “What’s Wrong with Me?” by Healthy Sense of Self’s founder, Antoinetta Vogels.

What's wrong with me?

This short eBook can help you start to unpack the real reasons behind your depression and low self-worth.

Or if you know someone who may benefit from reading this, please share it with them.

And share on social media for Mental Health Awareness Month this May.





This article was written by a member of the Healthy Sense of Self Editorial Team, Lindsay Dick. Lindsay takes pride in crafting content that’s clear, conversational, and draws people in with what we all want to hear: a good story. Her love for compelling narrative and rigorous research led her to pursue a history degree in college, the equivalent of Spartan military training for reading and writing. 


  1. Marie on May 9, 2019 at 11:33 am

    I suffer with mental health and I had serious suicide attempt last august was in icu for a week in coma and I’m still waiting for help and counciling. I don’t go our anymore my cofidence is a all time 5

    • Denise Kinsley on May 9, 2019 at 1:24 pm

      Does talking about your state of mind ease the suffering? Is there someone you feel comfortable with that can help to support you?
      Here’s a great resource: https://afsp.org/find-support/

    • Antoinetta Vogels on July 25, 2020 at 9:49 am

      We at Healthy Sense of Self are wondering how you are doing and if we could be of service

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