Secret Shame

Do you fear what others think of you? How shame can hurt your health.

Lisa would watch us with moist eyes from the classroom window during recess. Born with rheumatoid arthritis, she wore leg splints until the eleventh grade, at which point the splints came off and the brooding genius graduated high school early. Years later she told me that throughout adolescence she woke up depressed, pleading with her mom to let her stay in bed. Yet the shame of her childhood was soon forgotten at CalTech where she was quickly absorbed by a supportive group of variously stigmatized geeks. Others aren't so lucky.

Shame weighs on anyone who feels the burning gaze of onlookers (be it real or imagined). Worse yet, the pain can take a lasting toll on your health. Mounting evidence demonstrates that this kind of mental stress can physically exacerbate cardiac problems and depress the immune system, suggesting that we should monitor our personal insecurities as we would salt intake and cigarette smoking. For the sake of your heart and body, treat your self-image gently.

Stress—of all types—has been linked to depression, cardiovascular disease, and the rapid progression of illness. Sheldon Cohen at Carnegie Mellon, who has been studying the association, explains that the damage comes from two directions. People under stress often develop bad habits, like sleeping less, skipping the gym, eating junk food, smoking more, and drinking more. Second, the body reacts to mental stress.

Just as in movies, where men suffer heart attacks when they work too hard, catch the wife in bed with another man, or yell at unruly children, fear and anger have long been known to simulate fight-or-flight responses, in which heart rate, blood pressure, and stress hormones such as cortisol increase. In particular, too much cortisol can shut down or alter other body systems. For instance, high levels of cortisol are known to suppress the immune system. Cohen has found that cortisol increases can even influence the replication of the HIV virus.

But while the crestfallen stress of poor self-image may not seem comparable to the fiery feelings of anger and fear, this kind of sheepish worry can lead to physical damage as well. Not everyone agonizes about body image, excess fat, or a lowly position at work. But people who were more attuned to social cues in general showed more physical signs of stress. In one study, subjects gave a speech or solved math problems while so-called evaluators shot them discouraging glares. The shameful became more stressed out more easily.

Shame may be one of the more potent emotions, says Margaret Kemeny, a psychologist at University of California at San Francisco. "People think that all stresses have the same effect on the body, but stress caused by how others view you is extremely powerful, as much or more so than those caused from losing a job or working too hard."