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Shame – it’s the accompanying emotion to depression and anxiety. If you suffer from depression or any kind of anxiety disorder, you may be dealing with feelings of shame too.

It’s okay. You’re not alone.

When you’re depressed, you’re sad; when you’re anxious, you feel fearful. It’s not uncommon for people with one disorder to feel the emotions that are generally categorized as the primary emotion for another disorder. As conversations around mental health increase, many people are quite aware of the emotions of sadness and fear, and generally understand the depth and toxicity of these negative emotions.

But the other emotion that’s less talked about? Shame.

Shame is considered by experts to be a secondary emotion, or in other words, an emotion that is a reaction to another emotion. It’s a negative, diminishing feeling, because it makes us feel small for feeling our other feelings – not just sadness and fear, but anger and a host of other “bad” feelings as well.

Some people mistake shame for guilt, but it’s not the same thing. Guilt comes from re-evaluating our behavior, our actions. It’s about what we’ve done. Shame, on the other hand, comes from evaluating ourselves, our person. It’s about who we are.

When people feel guilty, it can be a driver for change – it can make a person motivated to perform or behave differently, thus becoming a better version of who they once were.

But when people feel ashamed, it can have a very different effect. They may not feel driven or motivated, but rather hopeless and withdrawn. Because shame is about who we are, as opposed to what we’ve done, it’s a deeper, more dangerous feeling than guilt.

So how do you know if you’re ashamed? And how do you know if it’s become a form of toxic shame?

If you’re frequently talking down to yourself (engaging in negative self-talk) and can’t remember the last time you felt great about yourself, you may be feeling a dangerous level of shame. While a lot of people partake in negative self-talk now and again, those who are depressed or anxious do it a lot more often than others – and the more frequently this internal conversation happens, the more debilitating the outcome.

How do you handle shame?

First of all, know you’re not alone in this. Shame usually comes from shaming messages we may have received as children, from members of authority like parents, caregivers or teachers, or even peers and friends we looked up to and loved. In other extreme cases, it can come from traumatic events like abuse. These messages we heard become what we tell ourselves, and even when we don’t hear them anymore, we keep repeating them anyway.

When you see a therapist, you will likely be guided to learn about cognitive restructuring, or positive reframing. It involves thinking about something negative in a more positive way, or identifying something beneficial about a challenge or an adversity.

Here’s an example.

When David was growing up, he loved nothing more than surrounding himself in books. He pored over textbooks he borrowed from the school library, and read his uncle’s tattered encyclopedias again and again.

His father, neither an academic or a reader himself, would scream obscenities at him at the dinner table or on Saturday mornings. “What is wrong with you?” he would shout. “Why aren’t you normal? Why aren’t you like all the other kids who ride their bikes? You’re a freak!”

The words cut, and David tried to be “like everyone else.” He tried to join sports teams at school, but was always eliminated. He tried to find television shows he enjoyed. But nothing felt quite as comforting and enjoyable as reading and studying.

David graduated high school with honors, and eventually got his bachelor’s and master’s degrees, but he felt little pride in what he accomplished. He thought there was something inherently wrong with him. It wasn’t until he was writing his PhD thesis that his eyes opened to his shame.

“I had a student say to me, ‘I don’t know what’s wrong with me… I never feel as good as I do when I’m ingesting information, when I’m learning,’” recalls David. “It was like listening to an audio recording of myself. But this was a brilliant, bright kid, someone I thought could never lack for confidence or pride.

“And that was the clicker for me. I had listened to my dad’s abuse for so long that I made it my own. I minimized everything I had accomplished, and until this student said the words himself and it was on me to tell him, ‘No, you’re magnificent and you should be proud of everything you’ve done,’ I hadn’t ever thought to say those words to myself.”

There is so much power in reframing your thoughts and stepping out of shame. Shame can be destructive, demoralizing, debilitating – and no one should have to live in that. Positive reframing is certainly something you can try on your own, but it’s especially powerful when you have someone trained to help you do it.

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