Disorder categories and taking medication, despite their practical and symbolic benefits, also carry negative connotations. Interview participants raised concerns about help-seeking, disclosure, mental illness, medication, and neurobiological explanation. These concerns are often acknowledged in anti-stigma campaigns but attributed to issues of blame and judgmental attitudes. But those were not the issues for participants. Rather, they were worried about implications of being “different,” of not being fully in control, both in their own eyes and those of others. To understand and situate these worries and the efforts participants made to contain or neutralize the threat to their agency, it is critical to bring another part of the background into view, the broader cultural matrix of social norms and identity-values. Predicaments involve challenges to self, to one’s being, and medical language and medication add to these challenges. In dealing with these challenges, people sought to carefully control disclosure and impose an interpretation that preserves and restores their autonomy and self-efficacy. They used various Goffmanian self-presentation strategies to mitigate and deflect identity-spoiling connotations and manage the meaning of their story.
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