It is both. The stigma is also still real. There have some been some shifts in it depending on what trades and what units you're looking at. There's still quite a bit of stigma in the infantry and the combat arms, but within the service trades the stigma seems to have alleviated a bit, but there's still that issue of, am I polluted, am I sick, am I diseased? The language itself creates an actual level of statement. The fear of being termed weak, or incapable, or not capable, especially with the hyper-masculine identity that all soldiers have, becomes a thorn that causes more harm.
On top of that there is a liability issue that's occurring and there's also—as I was alluding to in my previous response—this fear of losing their job, of losing your place in life, your meaning. This has to do with the whole thing of the universality of service—which I know you guys have heard about before—that the moment you're not able to be deployed, that's it, you're out the door.
Knowing there's a psychiatric condition, you're likely to be put on meds that are going to mess with your mind, which creates a liability issue, which in turn invokes the issue of universality of service; or, if you're not on meds, you're going to be on long-term therapy. My psychotherapy has been going on for several years and we're still just scratching the surface of the hell that occurred. If you're stuck in a position of requiring ongoing treatment for longer than six months, you can't be deployed, and therefore you breach the universality of service and you're out the door.
On all these levels there's a self stigma, there's a societal stigma, there's a liability issue, there are all these things. It's not one single thing that's actually causing all of it; it's this interwoven mesh that, especially when you're in crisis, makes it that I can't do that, I can't continue, but I need to continue, I can't reach out for help or it's all going to end.