Most people think the hardest part of a Mental health crisis is the illness itself. In my case that would entail the acute experience of psychotic depression. And it is often true that acute mental ill health is extraordinarily disorienting and frightening. I wouldn’t wish my previous symptoms of psychotic depression on anyone and they have been the hardest experience of my life.

However, the Mental health condition itself is not the only challenge inherent in an experience of mental ill-health and the subsequent pathway of recovery or management. For many with lived experience, the second biggest barrier to recovery isn’t the illness or its symptoms. It is the shame and stigma that follow a bout of mental ill health. And this effect gets stronger, the less normalised the Mental health struggle is.

Shame has a way of arriving late to the party. It waits until the crisis settles a little, your thinking clears, and the world expects you to “be on the road to being yourself again.” And that’s precisely when shame hits the hardest with its sting and long tail.

This is the recovery paradox: shame often peaks after symptoms improve, not during the crisis. And this paradox, often silently, slows full recovery or successful management for many people with lived experience of mental illness. An impact on recovery that is often more powerful and less studies than the illness symptoms themselves.

Why Shame Intensifies as You Get Better

During a crisis, the mind is focused on survival. Often there is little spare cognitive and emotional bandwidth for self-evaluation, social comparison, or judgment. But as symptoms begin to subside, something often unexpected happens:

Cognitive clarity returns and so does self-judgment, sense-making, and identity integration. Once your thinking sharpens, you can see what happened with more clarity.

The brain, in its renewed competence, starts reviewing the crisis like an internal audit: Why did this happen? Am I broken? Was it my fault? Why did I act like that? How did I not notice the signs? What will people think? Events, thoughts, emotions, and behaviors that you couldn’t process earlier, may drift back with a vengeance and often with startling detail. And this may rekindle embarrassment, fear, or self-stigma.

Social comparison also likely returns. Moreover, you may start noticing the gap between “your old self” and who you are in recovery. Even if no one else judges you, which is rare, you may begin judging yourself. People around you and society at large may assume that because the crisis is over, life should resume at normal speed. But healing doesn’t care about calendars, and emotional recovery often lags behind symptom resolution. A Mental health crisis can fracture your sense of self and recovery will likely force you to face the pieces and engage in a process of sense-making and identity processing.

Shame Meets Stigma: A Trouble-Making Duo

Shame or self-stigma is internal: “There’s something wrong with me.” Social stigma is external: “Others think there’s something wrong with me.” Most people recovering from mental illness don’t struggle because their crisis made them weak. They struggle because society taught them that needing help or experiencing ill-health, especially mental ill-health, is weakness.

Even subtle messages create pressure:

• “You’re fine now, right?”
• “That was just a bad patch.”
• “You’re so strong — must be great to be past it.”

People often mean well, but these messages compress recovery into something tidy and easily packaged. The real experience is anything but tidy. Stigma creates silence. Silence creates shame. And shame slows healing.

How Shame Actively Slows Recovery

Shame isn’t just an unpleasant feeling. It actively disrupts the psychological and behavioural processes needed to heal. Shame drives avoidance. People avoid follow-up care because they fear being judged or seen as relapsing. Shame fuels isolation. You withdraw from support, connection, and community — the very things that facilitate recovery. Shame increases self-surveillance. You watch yourself constantly, scanning for signs of decline. Hypervigilance is exhausting and can mimic symptoms. Shame feeds rumination. Instead of integrating what happened, you get stuck in loops of “What’s wrong with me?” or “Why can’t I just move on?” Shame delays help-seeking. People often wait until distress becomes unbearable before reaching out. Not because symptoms are worse, but because shame is louder. In short: shame disrupts the very processes our brains and bodies rely on in recovery.

A Lived-Experience Moment

I expected to feel relieved when my own crisis ended. And I did, very much so. But at the same time my shame grew, I felt exposed and as if everyone could suddenly see cracks that appeared in me. The symptoms of psychosis and depression had gone, but the shame was just beginning. As a psychologist, I understood recovery. As a human being, I didn’t understand why recovery felt so shameful and lonely. By now, several years later, I have learned that shame after a health crisis isn’t a failure. It’s a predictable and quite universal aftermath.

Reframing Shame: It’s Not a Personal Failing

Shame after mental illness is incredibly common. And not only common, but predictable too. Here’s what many of us don’t understand: Shame is a normal response to vulnerability. Shame often intensifies because you’re getting better in many ways. Shame is shaped by societal and internalized stigma, not personal flaws. Shame wants to keep you safe from future harm, not to punish you. Shame decreases when spoken aloud — and grows in silence. Seeing shame for what it is can change the trajectory of recovery.

What Helps People Move Through Shame

• Name it. Simply recognising “this is shame” weakens its grip.
• Tell one safe person one small thing. Connection dismantles isolation. In psychology, we sometimes call this “micro-disclosure.”
• Treat shame as part of the recovery process. Not a detour. Not a setback. A phase.
• Reclaim the narrative. “Something happened to me” is different from “Something is wrong with me.”
• Practice Self-compassion that is firm and grounded. Not fluffy affirmations. More like: “I went through something hard. I’m rebuilding. This is valid.”
• Seek clinical support not just for symptoms — but for shame itself. It’s a therapeutic topic, not an embarrassing one.

Symptoms may knock us down — but shame keeps us from getting back up.

Understanding the recovery paradox helps us break shame’s invisible hold and reclaim recovery with clarity, dignity, and hope. Healing isn’t just the absence of symptoms. It’s the slow, courageous work of making peace with what happened and fully showing up.