Fear of treatment, shame, and embarrassment are keeping a large number of people from seeking the help they need.

Experts estimate that one in four people have treatable mental or emotional difficulties, but up to 75 percent of Americans and Europeans don’t seek the help they need.

A recent study in the journal Psychological Medicine shows that the stigma associated with mental illness is still a major barrier to seeking treatment.

Researchers at the Institute of Psychiatry (IoP) at King’s College London examined data from 144 studies, which included over 90,000 participants from across the globe. They found that the stigma of mental illness remains one of the top reasons people choose to forgo care.

“We now have clear evidence that stigma has a toxic effect by preventing people seeking help for mental health problems,” senior author Prof. Graham Thornicroft said in a statement. “The profound reluctance to be ‘a mental health patient’ means people will put off seeing a doctor for months, years, or even at all, which in turn delays their recovery.”

According to the latest statistics from the National Institute of Mental Health (NIMH), 40 to 50 percent of all people with bipolar disorder or schizophrenia go untreated each year. The number of untreated people suffering from some other disorders, such as anxiety or depression, is even greater.

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The study concluded that the main types of stigma facing those with a mental illness included the stigma associated with using mental health services, and shame or embarrassment. Other barriers included fear of disclosing their mental condition, concerns about confidentiality, wanting to handle their problems on their own, and not believing they need help.

Those most affected by the stigma included young people, men, minorities, people in the military and, perhaps surprisingly, those working in the health field.

“We found that the fear of disclosing a mental health condition was a particularly common barrier,” lead study author Dr. Sarah Clement said. “Supporting people to talk about their mental health problems, for example through anti-stigma campaigns, may mean they are more likely to seek help.”

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Natasha Tracy, a mental health writer and recipient of the 2014 Erasing the Stigma Leadership Award by Didi Hirsch Mental Health Services, said the hardest stigma to beat is the stigma that “looks back at us in the mirror.”

Tracy helps her own bipolar disorder by writing about it on her wildly popular blog, Bipolar Burble.

“Every one of us sees anti-mental illness images and ideas in society and just getting a mental illness does make these go away,” she told Healthline. “We must consciously be aware of our own thoughts and feelings towards our own mental health and fight to ensure that any unhealthy thoughts are replaced by more reasoned ones.”

Acknowledging that it’s no easy task, Tracy said that it can take years for someone to get over feeling bad about having a mental illness. She said the important part is knowing that mental illness is a disease of the brain, just like pancreatitis or liver disease.

And just as with any physical illness, the pain of mental illness doesn’t go away unless you treat it. But instead of worrying about what others who doubt the necessity of mental health treatment think, focus on yourself and your own wellness.

“It can be difficult if people around you can’t accept your mental illness treatment but first and foremost, treatment is about getting you better and bringing people onside is a secondary concern,” Tracy said. “I recommend seeking out people who are supportive and using them to lean on at first.”