Reasons for disclosing depression matter: The consequences of having egosystem and ecosystem goals

Abstract

People with depression often conceal their depression and do not seek help, in part because of the stigma associated with mental illness. We propose two motivational systems for the self: egosystem motivations, concerned with protecting and inflating desired self-images, and ecosystem motivations, concerned with contributing or supporting others. Using a sample of 48 individuals at a Midwestern university, USA, this study examined motivations for disclosing or concealing a concealable stigma, to test the hypotheses that: (1) these motivations load on two factors corresponding to egosystem and ecosystem goals, and (2) ecosystem motivations for disclosure have more positive effects on disclosure and psychological well-being. We found that people with egosystem goals disclosed less, and also experienced lower psychological well-being when they did disclose. Conversely, people with ecosystem goals disclosed more and experienced greater psychological well-being while doing so. Implications of these findings for deciding when and to whom to disclose one's depression are discussed.

Introduction

People with concealable stigmas must decide when to disclose their stigmatizing condition (Goffman, 1963, Jones et al., 1984). A great deal is at stake, both for the person who could be stigmatized and for others. People who disclose a stigma risk the possibility of being stereotyped, rejected, discriminated against, and even the target of hate crimes (Goffman, 1963, Kelly and McKillop, 1996). When possible, people may choose to conceal stigmatizing characteristics (Jones et al., 1984, Link et al., 1991) to avoid potentially awkward interactions with non-stigmatized others (Goffman, 1963). Fearing embarrassment and negative judgment, some people decide to not seek professional help for their depression (Barney, Griffiths, Jorm, & Christensen, 2006). Thus, stigma can prevent people from disclosing their depression to health care providers – potentially their greatest source of support.

Simultaneously, disclosing a stigma can help both the self and others. Disclosing enables stigmatized people to both receive support and provide social support to others who have the stigma, thereby decreasing feelings of loneliness and isolation for the self and others. According to a recent review, contact between non-stigmatized and stigmatized group members leads to a reduction in stereotyping, prejudice, and stigma (Rusch, Angermeyer, & Corrigan, 2005). Because one's mental health status is not always readily visible, disclosure may be necessary to facilitate contact. Thus, disclosing to non-stigmatized others may reduce stigma.

Given the costs and benefits of revealing one's depression, why do people conceal or disclose? When do people determine that disclosing is too risky? When do they risk rejection to obtain needed support? We attempt to answer these questions by investigating motivations for disclosure.

In this article, we draw on our recent research and theorizing about motivational orientations for the self to identify factors that predict disclosure and disclosure's impact on well-being. Specifically, we propose that egosystem motivations undermine well-being, inhibit disclosure, and make disclosure a less positive experience. Ecosystem motivations, in contrast, foster well-being, encourage disclosure, and make disclosure a more positive experience.

We have proposed two distinct motivational orientations for the self, the egosystem and the ecosystem (Crocker, Garcia, & Nuer, 2008; Crocker, Nuer, Olivier, & Cohen, 2006). Virtually, any action can stem from either of these motivational frameworks, or a blend of the two. People have relatively stable average levels of egosystem and ecosystem motivations, but situations (e.g., domain, interaction partner, situational cues) cause variations in those average levels (Crocker & Canevello, in press).

In the egosystem framework, the direction of motivation is toward the self; people focus on satisfying their own desires and needs, giving them priority over the well-being of others. Constructing and maintaining desired self-images, obtaining social resources, and avoiding social harm comprise central egosystem goals (Leary and Kowalski, 1990, Miller, 2006, Pyszczynski et al., 2004). Constructing desired images requires doing things to ensure that other people see and acknowledge those qualities in the self (Leary & Kowalski, 1990). Research and theory suggest a core human motivation to construct, maintain, and defend positive images of the self and to see the self as worthy and valuable (e.g., Greenberg et al., 1993, Leary and Baumeister, 2000, Steele, 1988).

Drawing on the biological notion of an ecosystem, Crocker et al. (2006) used the term “ecosystem motivation” to refer to a motivational framework in which people see themselves as part of a larger whole; a system of individuals whose needs are equally important, and whose actions have consequences for others, with repercussions for the entire system, ultimately affecting the ability of the individual to satisfy his or her own fundamental needs. The direction of motivation is toward others: people consider others' needs and well-being, and prioritize them along with the well-being of the self. In this framework, people do not act at the expense of the self, but rather these goals are more like a form of enlightened self-interest (Batson, 1998). Consequently, people with ecosystem motivations prioritize the needs of others, not out of virtue or self-sacrifice but rather to satisfy their own and others' fundamental needs.

We suggest that egosystem and ecosystem motivations help explain when people disclose and have a better experience doing so. Specifically, we propose that these motivations will influence both psychological well-being and disclosure.

Ecosystem motivations may help depressed people break out of their negative, ruminative self-focus, thereby increasing their well-being. People with depression tend to experience a heightened self-focus state (Nolen-Hoeksema, 1991, Pyszczynski and Greenberg, 1987). When people have a heightened self-focus, they perpetuate depressed mood states by focusing exclusively on themselves and not considering their external environment (Pyszczynski & Greenberg, 1987), which detracts from effective problem solving strategies (Nolen-Hoeksema, 1991). Thus, egosystem motivations, which primarily focus on costs and benefits to the self, may be particularly prevalent for people with depression, and be associated with lower psychological well-being. Conversely, ecosystem motivations, which focus on the needs of both the self and others, may help people terminate ruminative self-focus and lead to greater psychological well-being.

In fact, recent research shows that egosystem and ecosystem goals affect well-being, and they do so more strongly for dysphoric than nondysphoric people. In one study, participants completed brief questionnaires about their current activities, their reasons for doing the activity, and their well-being approximately four times a day for 2 weeks (Crocker, Breines, Luhtanen, & Denning, 2006, Study 1). Results revealed that participants experienced lower well-being when they completed their current activity because it had value for them (egosystem motivation), but higher well-being when they did their current activity because it had value for others (ecosystem motivation). These findings were stronger for depressed participants. Similarly, in a study of incoming college freshmen, students with chronic ecosystem goals (averaged across 10 weekly reports) showed decreased symptoms of depression from the beginning to the end of their first semester of college, whereas students with chronic egosystem goals showed increases in symptoms of depression (Crocker, Breines, & Flynn, in preparation). These two studies provide evidence that egosystem goals related to lower well-being and ecosystem goals correlated with improved well-being, especially for people who feel relatively depressed.

When people fear disapproval, they only disclose information that is not very intimate (Meleshko & Alden, 1993). We propose that fear of disapproval or rejection leads people to conceal a stigma if they have egosystem goals, but not if they have ecosystem goals. When people have egosystem goals, they want to maintain and enhance self-images and obtain desired social outcomes such as acceptance or admiration. Consequently, when stigmatized people expect rejection if they reveal their stigma, they will attempt to conceal it from others.

Ecosystem goals for disclosing stigmatized identities, such as depression, include consideration of the needs and well-being of others, in addition to the self. Instead of focusing on inflating or protecting the self, ecosystem goals focus on supporting others or contributing. People with ecosystem motivations might be willing to risk disapproval for the sake of creating authentic relationships with, educating, or supporting others. Consequently, when they have ecosystem goals, stigmatized people may disclose their stigma despite expecting rejection, or even because they expect rejection and consequently want to educate others about their stigma. Thus, we predict that people disclose their stigma more often when they have ecosystem goals and less when they have egosystem goals, and the effect of these goals on disclosure should be stronger when people expect rejection.

We used experience sampling methodology (Hektner, Schmidt, & Csikszentmihaly, 2007) to examine the relationships between egosystem and ecosystem motivations and psychological well-being and disclosure. Experience sampling methodology allows researchers to examine participants in their natural setting over a sustained period of time. We asked participants to indicate their motivations to disclose their concealable stigma over 2 weeks, which enabled us to examine both the immediate and long-term effects of having egosystem and ecosystem motivations to disclose.

Two stigmatized groups participated: people with depression and sexual minorities. The inclusion of sexual minorities in this study allows us to ascertain if the effects of egosystem and ecosystem motivations on disclosure and well-being apply to other concealable stigmas or are unique to people with depression. Thus, sexual minority participants serve as a comparison group in this study.