Mental Health Month “All queered out”

The relationship between the LGBTQ community and Mental Health has long existed. Someone who believed same-sex relationships to be a sin, may point to the mental health ‘sickness’ of those who are attracted to partners of the same gender. This goes back to the seventies where mental health and being queer or transgender, was considered a mental defect/illness. It was not until the early seventies that the bible for Psychiatrists changed this diagnosis and it no longer was considered a mental illness.

During this time of stigma, those who admitted to being queer or transgender were often subjected to camps and programs that attempted to ‘cure’ them of their ‘proclivity’ of course they were unsuccessful but they did a great job of messing up generations of queers, so much so that many stayed in the closet, marrying and having children and never ever admitting who they really were.

Someone who is anti-gay may argue, that means they have a choice because they choose to stay in the closet and marry, they can be normal after all!

There is however, nothing normal about pretending to be someone you are not, and this definitely can be one reason LGBTQ people suffer from a higher than average degree of mental illness.

If it’s an argument of which came first, the chicken and the egg, then you can cross-compare to other studies looking at marginalized and condemned groups such as racial minorities, and see that levels of mental illness rise when bigotry and condemnation in the larger society are directed toward that group. No surprise, hate begets mental illness. It’s not all in your head!

How can hate cause someone to be mentally ill if mental illness is not a mailable and ‘chosen’ ailment? Hate cannot cause someone to get cancer, so how can we argue mental illness is as serious as cancer?

Hate can lead someone to drink too much, smoke too much, and that can cause cancer. It is called an indirect relationship. Cause and effect. The same is true of hate and the LGBTQ community, if you are condemned, judged, shamed, picked on, hated and treated badly day after day, that can literally drive you out of your mind. More commonly, a pre-existing tendency toward certain mental illnesses is exacerbated and tipped over the edge.

This does not mean, anyone ‘chooses’ to be mentally ill, but like anything in life, extreme stress CAN bring on symptoms. They have long known this with Schizophrenia, Bipolar and Borderline Personality Disorder and of course, PTSD has its roots in society as does anxiety. You cannot remove societal influence from the development of a mental illness yet it is as ‘real’ as any other disease in terms of true manifestation and side-effects.

Historically gay and minority populations experienced a high degree of stress and fear. They were having to hide who they were, meet in secret, they could be arrested because their emotions were illegal if expressed physically, and they often had other concerns such as low-income, poor access to care in the community, nobody to talk to honestly and unanswered questions about their own identity.

Our society is typically Heterosexist and Heterodominant because the vast majority of people in our society are heterosexual. It is one thing to show two women kissing, and have a bit of bisexual fun, quite another to be a committed full-time lesbian. Most people don’t relate to that, they may try to understand but that’s like a white person understanding the experiences of a black person, you can only go so far with that.

Thus, LGBTQ are misunderstood at best, and not understood at all at worst, with pastiche and parody being the status-quo. Historically this was even more so, as it was an illegal ‘act’ to be with someone of the same gender sexually (and everyone considered the deviancy of gay sex to be the key to being homosexual rather than thinking for a moment it could be about something other than sex).

Unfortunately a large portion of gay men were so promiscuous it did not help the ’cause’ because they really did live the life style that heterosexuals feared. I do condemn this in the sense that I see no good coming out of sleeping with twenty strangers a night, and whilst that may seem homophobic of me to say, having read the history of HIV and AIDS I see a causal history there as to why homosexual men became one of the earliest groups to be significantly infected by HIV/AIDS. This set the gay cause way back because straight people condemned all gays outright for the actions of the few, and believed HIV/AIDS to be a gay-plague, which of course it was not.

Reading the history of this time, I tried to better understand what would lead gay men to be that promiscuous, my first thought was, a lot of straight men would do the same thing given half the chance! My second thought was, it’s about reaction. Gays were subjected to such strict secrecy and condemnation they could not really be ‘out’ and when finally some cities were tolerant enough to be relatively out, certain populations ran with it. I understand the reaction/action/reaction cycle it exists in every subjugated population to some extent, and every new generation reacts to their parents, it’s a cycle of over-throwing the old for the new. But the level of promiscuity in cities like NYC and San Fransisco was a contributing factor as to why HIV/AIDS initially hit the homosexual male population so hard.

When we consider what a heterosexual who knows little about homosexuality must have thought upon hearing that some homosexual men with HIV/AIDS were sleeping with twenty plus partners a night, as well as doing drugs, it’s not hard to see why there was another wave of backlash against the gay community en mass.

That said, times have somewhat changed and whilst you can still find ‘bath houses’ and gay men (and some lesbians!) who wish to be as promiscuous as those early days, there is also a greater appreciation for actual relationships among the homosexual population. This should be emphasized more in our culture, as heterosexuals still believe homosexuality is about sex, and it is often a very small part of what goes into being a homosexual. The stereotypes are hurtful to the community as a whole, those include the idea that all lesbians are ugly, all queer men are paedophiles, all lesbians are men haters, all bisexuals are sex-addicts, all gay men are perverts.

Going back to mental health … when HIV/AIDS first hit, there were not enough resources to help the gay community, and there was therefore, even less help mentally. After the crisis began to die down and some treatments that worked began to help people live longer and HIV/AIDS was no longer a literal death-sentence a strange thing occurred…. there was a mass influx of extreme depression among the survivors of the ‘gay plague’ as it was known.

Survivor guilt and the depression that comes from severe illness and PTSD (seeing all your friends die) are HUGE factors in the development of mental illness. Some survivors actually deliberately stopped taking their HIV/AIDS medication and let themselves sicken and die because of not being able to stand surviving. They felt they didn’t deserve it. Why me and not my friends?

This was exacerbated by virtually NO resources for gay individuals who needed to talk about what they experienced, witnessed and felt. This still stands, in most cities throughout the US there are no specific mental health services for the homosexual and bisexual and transgender populations.

During my studies as a psychotherapist I sat in a large room with over a 1000 counselors on a briefing about ‘homosexuality and mental health’ during which everyone was told that to be homophobic or intolerant of homosexuality, was incompatible with being a mental health professional. Sounds good huh? Not so good. Of the 1000 there I would easily hazard a guess and say that a third, possibly half, were somewhat prejudiced, very ignorant and possibly homophobic. I say this after hearing them speak, the questions they asked, the people they were.

This is not condemning someone who is homophobic, any more than I would someone who is racist. It is your right. But it’s not legal and it’s not moral. So given this, those people have the difficulty of being legally required NOT to be what they actually privately are. Do you think many of them would admit this? Do you think they would stand up and say ‘I am against homosexual relationships’ and possibly lose their license? For those who are homophobic or anti-gay, you may be shaking your heads and saying ‘this is why it should not be legalized, you are forcing people to feel what they do not’ and I agree with the latter statement.

If you are homophobic you probably shouldn’t be a therapist with the exception of working in a religious community for like-minded people.

If that sounds extreme, well it is. Just as I would say if you are racist you should not work in a public setting but you would be fine in say, a community that supported your views and this cuts both ways (white and black).

LIkewise, if you are sexist, don’t work with the opposite gender.

I’ve been told that when you are a ‘ist’ you should work through your feelings and you should take clients who push your buttons. I don’t agree. Therapy is a fragile experience, and people pick up on intolerance. When I was training I saw and heard enough people to see, they KNOW when you are not comfortable with them. The same goes for ignorance, there is no place for ignorance and therapy when it comes to treatment. If you don’t understand it, refer, refer, refer. To someone who does.

The problem is funding, there are no funds for the queer community because it’s seen like Planned Parenthood as a problem more than anything else.

So if gays don’t have access to good mental health services (and other services) is it any wonder they have higher percentages of certain diseases and mental health issues?

The bottom line is; LGBTQ populations exhibit higher levels of anxiety, depression and alcohol/drug abuse than the standard population. This is not because they are all sex-addicted club fiends who pour drugs down their throats whilst sleeping with twenty partners a night. But the reality of this does lead ignorant people to label mental health as a weakness and point to this as an example. Some even go back to the idea that mental health is a perversion of nature, just as the pilgrims did when they put mentally ill people to death or locked them up.

It doesn’t take long to learn about a group of people you have nothing in common with and it can go a long way. Typically Native Americans ask that therapists working on reservations be of Native American heritage. Some say it should not matter who the helper is, it is more about their willingness to help.

I disagree. It does matter. Just as if you are black and you have been subject to racism you may wish to see another person of color, there’s nothing wrong with that, just as there is nothing wrong with being female and wanting a female gynecologist or therapist.

More gay people need to educate the majority about the specific issues relating to their population so those heterosexual therapists can actually be of some help to queer populations. Even more than that, those therapists who are anti-gay or prejudiced should recuse themselves. Yes – step away – don’t see homosexual patients – do them a favor!

Currently the accepted protocol is to be objective and even if ‘you are personally anti-gay’ you can be objectively helpful to a gay client. That’s ridiculous, no you cannot. I have a friend who is fairly anti-gay and works as a therapist and he is not ever going to be helpful to a gay client and can do more damage than good. Period. I have told him this but until the system changes, his boss and other leaders will insist that anyone, irrespective of their personal beliefs, treat gay clients.

Let’s change this…. and some other things and maybe the rates of mental illness will begin to decline in the LGBTQ population and with it, the high rates of suicide.

 

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Mental Health Month “the stigma-ism’s”

You can get rid of mental illness by …

believing in God more

working harder

socializing more

going to the gym regularly

quitting bad habits and making good ones

replacing negativity for positive thinking

sucking it up

reducing how often you ruminate

and so the list goes on

The problem with all of the above, whilst absolutely good habits for most of us (bar sucking it up) are, they imply therefore, the sufferer of mental illness is not doing enough to help themselves and ultimately they leave the after taste of judgement.

So how do you strike a balance between helping someone or seeking to help someone with a mental illness and coming across like ‘if only you did this, you would be well’ and thus, not understanding mental illness isn’t a lamp, it doesn’t get switched on and off easily, mental illness isn’t a fad (though it isn’t always life-long either) and (some) mental illness isn’t easy to dismiss with will power alone.

Why do we judge?

Why do we stigmatize?

Have you ever thought about that? What is within most of us that causes us to judge others?

If you really think you have NEVER judged someone unfairly or harshly award yourself the “unlikely” prize!

If you really think you have a right to judge someone else regularly, it’s probably best to stop reading now.

Judging has its place. If someone kills your entire family in front of you, chances are at some point you will judge them and find them guilty. Those who have lost family members to these examples of violence, typically say they have to forgive the perpetrator to some extent to prevent it consuming them, or they have to work through the hate and get to a better place. It is not ‘necessary’ to try to understand why someone would do something so evil, but usually in our effort to understand, our first port of call is judgement.

Why did you do this wrong thing? Why are you the way you are? What is wrong with you?

In the case of the murderer of an entire family I doubt many of us would have an issue with their being judged. That’s where judgement comes in handy. Law and order. Justice.

But what about every day life? Why do we go around judging things all the time thinking we are the judge and jury and even executioner (figuratively speaking) what is it about human beings that makes them relish judging or attracted to judging others?

Is it as simple as being insecure? Putting someone lower than ourselves helps us feel better in a twisted way?

Is it as simple as egocentricism? I know I’m right, therefore if you do the opposite of what I believe, you are wrong?

Is it blind faith? This is my faith and belief, anything you do to contradict it or throw it into doubt, means I will turn on you and condemn you.

Is it a knee-jerk reaction out of not understanding? Condemning what we do not understand?

Is it fear? Fearing we are more alike this person whom we judge than not, and thus, pushing them away by judging them, making it clear we are different so nobody will consider we are also guilty?

I don’t know the answers. What do you think?

What I do know is nobody likes being judged. Sometimes it’s useful or necessary in extreme cases like the one about the murderer, or in small incidences where we help someone learn or grow as a person – but this is more advice-giving than actual outright judgement. Outright judgement tends to have no benefit other than to shame that person. If they are guilty of rape, child abuse, murder, swindling, theft, I don’t have an issue with judging someone guilty and then giving them a consequence depending on the seriousness of the ‘crime’ that’s law and order, but in our society we judge continually in casual ways that we may believe have no lasting impact.

And yet … they often have a life long impact.

Cruelty goes hand in hand with judgement. Often the two are nearly indistinguishable. Mental health can be affected by bullying, judging, condemnation, shame, humiliation, etc. Ask yourself, do you feel judging will help anyone? Will it make anything better? Or is it just your desire?

Ever heard the phrase, you can think it but don’t say it? Sure you have. I’m one who is all for the truth, I would rather someone said something to my face than thought it and kept it quiet, but I’m in the minority, most people seem content to be ignorant of the truth of what someone thinks of them, preferring that they not share the negative assessments/judgements they may have.

Next time you find yourself tempted to say something judging, ask yourself, are you judging because you want to make something better and will that judgement achieve that goal? Or are you judging because YOU CAN AND YOU WANT TO.

Then put yourself in the shoes of the person you are judging.

Sometimes its soooo tempting to want to bring someone down a peg or two. You’ve all met one of those, the people with huge inflated egos who boast and seem unbreakable. Haven’t you been tempted to give them a piece of your mind? Or dent their parachute? At the same time do you really know the egocentrism they display is real? Could it be an elaborate construct and underneath an insecure person hides?

If you have to judge, consider judging those who judge others. If there is anyone ‘deserving’ of being judged it is someone who does it for a living. Next time you hear someone being torn apart, defend them, stand up for them, shame the judger. That’s the best way to use our proclivity for judging, for the benefit of the underdog and others who are picked apart.

Words stay forever. You only have to be told once that you are ugly, worthless, a failure, stupid, to believe it. If that seems weak, look at a childs face when they’re told that by a parent or someone who matters.

Mental Health Month “Inferiority”

The next time you come across someone who has a mental illness, consider the following…

We poke fun at people calling them mentally ill (Trump) without really considering the effect such labeling may have on someone who IS mentally ill. In poking fun we are looking to someone we do not respect and saying ‘they’re mentally ill’ by implication, someone we do not respect is mentally ill – this is all bad.

Just like saying ‘he’s so gay’ or ‘that’s so gay’ you may mean nothing by it, (good grief who hasn’t said it at least once?) but it is implying a negative connotion.

White people cannot and rightfully so, use the N word, but black people can because they own the rights to that word over anyone else. Likewise if you are gay, you could say to another gay person ‘you are so gay’ and it wouldn’t be offensive because it’s about who is saying it to who. So the same applies to derogatory statements about mental health. If two people are sitting in a psych ward and say “Trump is mentally ill” that doesn’t have the same emotional fall out as if someone who is not mentally ill makes the claim.

That may be hard to undesrtand but it’s about sensisitivity and it’s just like any category of people. A Native American can make jokes about Native Americans but an Anglo person cannot. Is that Political Correctness run amock? Not really, when you consider the history behind this.

Much as I have heard some awful sexist jokes and the only person who could tell them should be a woman, and not even then. Bottom line; Don’t go there, it’s not worth it.

I would argue, black people are better off NOT using the N word, and the same applies to any group who may use derogatory jokes/statements about their group in jest, it’s probably not very funny. If that’s too PC then so be it, I don’t see it as a detriment to world humor if we reduce how many off-color jokes we tell.

Ultimately what we relate things to says a lot about what we think of them. If we compare mentally ill people to someone they know we despise, then it’s a criticism whether wrapped up in a joke or not. Next time you are tempted to joke about mental illness consider whether it’s really worth the punch line and the laughs, and whether it’s really funny or just a means of exploiting an already stigmatized group of people. If that seems too serious, so be it, mental illness IS serious just like racism is, sexism is, prejudice is.

What does the mentally ill person feel when they hear jokes and put downs related to mental illness? Inferior.

One may say, a person who suffers from a mental illness is already subject to feeling of inferiority and this is probably the case, therefore they are vulnerable to begin with, and every subsequent insult and attack adds to that feeling.

Again, I have heard people lament the ‘weakness’ and over-sensitivity, of mentally ill people. The typical taunt being; “Why do you have to be SO over-sensitive?”

I would argue, what does it take to be a little sensitive around someone you know is going through a hard time? What does it actually TAKE?

There are many people who identify or are HSP (Highly Sensitive People) and this is not always related to mental illness but the two have a relationship because of the difficulty  of being an HSP in a world of mostly harder-nosed types, proud of their ability to not be sensitive, who see any sensitivity as a weakness and are not afraid of saying so.

I’m not going to labor the point about the value of having sensitivity or the obvious detriment to compassion if we do not have any, because I know there are two sides to this, and with such extremes it is unlikely they will agree. I would only ask that less judgement and condemnation exist, permitting those who are sensitive to go about their lives unmolested.

If you are a HSP and have a mental illness, your struggle is often magnified by the accute awareness of your situation and others reactions and responses to you. If someone makes a joke at your expense that wounds you on a deeper level than those who are able to shrug it off. For some, sensitivity is perceived as a weakness of character and their attitude is one of a bully who takes pleasure in seeing the sensitive person react. If you know someone like that, maybe now is the time to call them on that.

The TV show Thirteen Reasons Why may not be a good example of mental illness, and is lacking in many ways, but one truism is the development of hurt in the main character by the insensitivity around her. This can be a determining factor that leads to the taking of your own life, as in her case. I would argue that she also hurt others, and this was not explored in the show sufficiently, nor was mental illness really examined which it should have been. But irrespective, it highlights the progression of hurt to someone with presumably a pre-existing mental condition, that acts as a trigger to take her own life.

We can be part of a reason why someone is crushed. We may not realize we have that power, and maybe knowing we do, will make us a worse tormenter, but if we want to avoid hurting others, which I hope most of you do, then considering what our words do to those who are more sensitive, doesn’t take very long, doesn’t cost anything and can literally make such a difference. It can stop someone who already is feeling inferior from feeling so inferior that they see no purpose in going on.

Everyone is equal. Nobody is inferior to someone else until they act badly and show their true colors.

 

Mental Health Month “Friends without benefits”

Friendship.

Watching TV shows, reading books, the influence of an ideal, ‘friends forever’ the friends who are there when you need them, friends for life, friends through thick and thin.

Probably should preface this with “unless you are mentally ill”

Why?

Mentally ill people struggle to maintain life-long friendships and connections. An unkind soul may say “can you blame anyone for not being able to put up with THAT?”

Yes.

One reason mentally ill people struggle is the sense of isolation, loss, abandonment, and judgement, all discussed before. Friendship and ties to the community is the basis for survival for most people. Isolation and rejection can lead to suicide and worsening illness. It is not the duty of anyone to befriend a mentally ill person but equally as a society if we put our rapid judgement aside and turned from only seeking ‘fun happy people’ to socialize with, and gave a little thought to those suffering, our empathy would go a long way.

We are selfish on the whole when it comes to friendships. We don’t want to ‘bother’ too much, we don’t want to make an effort. We want something easy and fun. If it’s not we’re likely to drop it.

But the effort we put into our children, our families, our marriages, should equally be considered when looking at friends in need. If we cannot be a good friend are we even a friend? Or are we just a fair-weather friend?

Many people I have spoken with have talked about how much it hurt to be ‘friend dumped’ and how often this occurs when they are going through a hard time. The worst being, it can compound the already existing feelings of worthlessness and self-blame.

It is not the responsibility of others to take care of mentally ill people but it begs the question … if you are only friends with someone when the going is good, are you really friends? If you only want to be friends with someone without any strings attached and no difficult times, how invested are you? In short, are you even a friend?

Friendship is perhaps an art that is lost on us these days, with our increasingly ‘busy’ lives and selfish preoccupations. But remember, society functions well when all of us care about those in our society. If we simply live for ourselves and give no regard to others and their well-being, are we really the good and giving people we envision ourselves to be?

If we are Christian is this the Christian way? If we are Buddhist is this the way of the Buddha? If we are aiming for empathy and treating others as we would hope we would be treated, are we acting accordingly? What would happen if we suffered from a mental illness? What would we expect?

It is worthwhile considering this. A close friend of mine became incredibly ill with a brain tumor and she observed that she lost many friends, including those who went to her church. It showed her the time observed adage that you know who your friends are in your moments of crisis and need. This is where physical and mental health share something in common, in both instances, people flee the individual like rats from a sinking ship.

Finally we can say this is something both mentally ill and physically ill people experience. But why?

People are afraid of illness. They see someone with a brain tumor and act like it’s contagious. They know it’s not logically but this is an instinctive fear. They want to avoid sadness at any cost, they want to avoid reality at any cost, nobody wants to dwell on the possibility of death. It takes a very strong soul to want to go there.

Consequently at your time of need, the very hour you really need people there, you are deserted. Before I began visiting the hospital regularly I was completely unaware of this, I had no idea how many hospital rooms were emptied of visitors and support systems, how many go without any friends to comfort them in their hour of need.

I recall as a kid going to see a friend who was diagnosed with schizophrenia in the state hospital and how he talked about losing all of his friends. It seems like not much has changed.

And ask yourself this … how much would it take to care?

Recently another acquaintance developed Terminal Stage 4 Ovarian Cancer, when asked, her colleagues, who had worked with her for TWENTY YEARS put off going to visit, until someone posted on Facebook ‘she’s going to die! Go see her before she does!’ and then, the herd mentality took over and everyone went to visit. It was ingenuous and false, and I came to see, these people who had worked with this woman for two decades, really didn’t care, they wanted it over with.

I understand the knee jerk response to death and all things unpleasant, but we’re all going to die, is this how we would wish others to react to us? Empathy means, consideration of how we treat others, as much as how others treat us, and the two are connected by an understanding that it cannot be a one way street. As painful as it may be, supporting those in their hour of need is what makes the world a better place. If we are too busy to attend to that, what does it say about our priorities?

The same applies to the mentally ill. This can literally be a life saver, a life line, a much-needed support network. Suicide often occurs because of isolation and a feeling that the world would be a better place if I were not in it. Surely losing friends and being ignored, adds to that feeling and thus, the reverse is true if loyalty and constancy exist.

Obviously some friendships have an expiry date and that’s okay, that’s the nature of the beast, but if you’ve stopped calling someone because you are fed-up with their mental illness and it’s not ‘fun anymore’ consider this, what would you want if you were going through the same thing? Should friendship simply be about benefits?

Mental Health Month “The Workplace”

Ask many people with mental illness, how’s the workplace? Many will describe the frustrations of trying to work alongside people who either do not know or do not understand the struggles they are going through, the high rates of unemployment, underemployment and patchy employment relating to mental health.

We hear how many working days are lost to mental health, we know this, but as a society we do nothing to improve the resources for those experiencing mental health challenges. Again, for those who have not experienced any mental health issues, they may wonder, what could be so bad as to take people out of the work place?

Where to start? Panic attacks can make going to work feel like a torture. Anxiety can cause reduced career opportunities because of fear, phobias including agrophobia may make it hard to actually venture beyond the house to a place of work, depression may keep a sufferer in bed on days when they are most needed at the office, bipolar can cause a worker to shift from highly productive to shut down over night. Without a full understanding of the complexities of mental disease, your boss is likely as not, ill equipped to handle these things and that is why so many people with mental illness struggle in the work place.

But what are we doing about it?

In recent years, bullying in the workplace has been a topic of discussion and highlights that we have not progressed as far from the playground as we may think. Typically people with mental illnesses are far more likely to be the object of bullying both in the school yard and work place. We hear about work place violence and assume some ‘crazy person’ came and gunned down some innocents, and whilst there is no justification for work place violence, is there any excuse for work place bullying?

It is worth considering this if you work with someone who is being bullied. Stand up for them, let someone know it’s happening, don’t let those tensions get out of hand, and then wonder what you could have done about it after it’s too late and that person commits suicide or brings a gun to work. Equally, if someone is mentally ill and they’re making it hard in the work place let your boss know, so that they (whose job it is) can do their best to resolve the issue.

Let’s look at an example;

One

Jemima is a closeted lesbian who suffers from anxiety. Her work colleague grows suspicious of her ‘life style’ and watches her type in her password, when Jemima is out at lunch, her work colleague ‘hacks’ her email account bringing up private emails of Jemima’s to her girlfriend. The work colleague prints them out and everyone in the office giggles over their content, unbeknown to Jemima. One person in the office feels this is wrong but doesn’t know what to do. What should they do?

This is a true story. The outcome was, nobody did anything, and Jemima ended up leaving her job, feeling that she had no choice after she found out what had happened and experienced severe anxiety and feelings of shame and bullying. Some would blame her for being in the closet, whilst others would understand, sometimes it has to be that way. But what could have changed to prevent this? If one person had stood up and told Jemima’s boss, then thanks to legal changes protecting people’s private-lives, her boss, whether approving of Jemima’s ‘life style’ or not, would be legally bound to act. If they did not act then this could be protested. Additionally, Jemima’s colleague who objected to this hacking, could have told Jemima and urged her to go to HR and report this as a violation. By doing nothing, nothing gets better.

Sometimes when you stand up. You make a difference. It really can take one person to do it, think of Rosa Parks.

Case Two

Jose is Bipolar but feels if he tells anyone at work he will be fired because that’s happened in two previous jobs so he says nothing. When he gets insurance through his job he does not go to see a psychiatrist because he fears his disease being part of his permanent record and worries this will stigmatize him in the future. Consequently he pays for private care and spends a lot of money on medication.

One week he does not have any medication left and doesn’t have the money to replace them. He begins to get the side-effects of not being on his medication including being unable to sleep at night, paranoid thoughts, inability to concentrate and feelings of mania. He is not able to tell anyone what is going on, tries to do his work at home but because of not being well doesn’t do a complete job.

When he returns to work after getting paid and getting more medication his boss tells him he has to let him go because of poor performance. Jose loses his job and now does not have the money for his medication or any health insurance.

What could have been different here?

The American laws concerning healthcare protect us somewhat from workplace discrimination. This is not inclusive and it’s fallible because people can and do make up other reasons for firing their employees. If in doubt speak to the workplace commission in your state about what your rights are, knowing your rights is half the battle. Likewise, Jose’s boss would be breaking the law if he chose to disclose Jose’s health status to anyone else at his work place, so in this sense, choosing to speak to his boss about what was going on, protects Jose more than staying quiet.

The reality is however, that until stigma around mental health is gone, there are always ways to subvert someone based upon prejudice. If your boss is predisposed to thinking ‘everyone with bipolar is a nut-job’ they may circumvent the law and find a way to get rid of you despite your best efforts. Having anyone else on your side improves your chances, as well as letting the proper legal channels know. Ultimately however, not enough is done to self-guard those with mental illness in the work place and this is one failing that needs serious remedy. After all, we need an income to afford health care one way or another, if we cannot get a job, how are we expected to get treated?

The reality of mental illness is many people are in the closet about it, for a plethora of reasons, and until we reduce the stigma and judgement as a society, they have no incentive to come out. Mental illness does not mean you cannot be an asset to any job, but a level playing field means a fair one, where there is no condemnation or presupposition based upon a mental illness diagnosis.

For a GREAT example of mental illness at work – watch the TV series HOMELAND with Claire Danes. It’s one of the most realistic (as far as anything on TV goes) portrayals of the struggle against the system by a young woman with Bipolar 1.

 

Mental Health Month “If you weren’t so lazy!”

We’ve all heard the mom of a teen accuse them of being lazy. If you just did more, you could accomplish xyz.

For a teen who prefers bed to getting up going to school it’s not a big deal. When it’s a depressed person or anxious person who is told this, it’s tantamount to character assassination but how can we tell the difference between laziness and the inertia that is one of the side-effects of prolonged depression?

Laziness is where you don’t want to do something enough to do it.

Inertia is where you may wish to do something but cannot summon what it takes to do it.

And if you are able to get up and do something, then does that mean you’re lazy when you cannot? If you have the strength to achieve one day but not the next, is that saying something about your will power?

With the best will in the world anyone who has had anxiety/depression or some other mental illnesses, will attest, they’d like nothing better than to wake up feeling like they want to go jogging with their friends along the river side, or take a boat ride out on the lake, or read a book they’ve been dying to read, or start fixing up that DIY home-project of replacing the windows.

A lazy person chooses not to do these things, they may not even want to and prefer to have someone else do them.

It isn’t a choice if you simply cannot do it despite every desire to.

But surely if you put more effort in?

The impact those kinds of statements can have is dangerous. What’s the implication? Someone who doesn’t (fill in the blank) is not pushing themselves, making enough effort. Bottom line – failure.

If you are feeling depressed or anxious, chances are you are quite aware already of how disappointing it is, not to be able to do what you want to do. Being reminded of it, doesn’t motivate a person. It is not the same as pulling the teen out of bed because they are sleeping in and wasting the day, and we do a disservice to those who are depressed by thinking they can snap out of it ‘if only they do this’

But like anything it’s a fine line, because on the other hand, allowing someone we care about to be depressed and ‘wallow’ is not the answer either. Numerous studies attest to the benefits of not locking yourself away from others, avoiding the world and stimulation, when depressed. It may feel bad to get out and do things but guaranteed, it is worse to stay home and dwell. The distinction is in how we use language, avoiding blame phrases to ensure we’re not condemning someone inadvertently.

Depression like any disease can lead people to feel ‘half-alive’ and the last thing you want to do when you are half alive is go swimming or BBQ or socialize. Sometimes if it’s really bad there is nothing for it but call in a mental health day and spend it doing something comforting, hoping the crisis will pass. But if you find yourself in a rut, the loathed things may be the very things you do need to try to do.

If someone in your life makes you feel badly for not ‘trying hard enough’ explain to them depression is a consistent effort, of trying to do things others don’t even have to try to do. Help them understand the analogy of trying to push a bolder up a hill single-handed each and every day. Then next time they imply you’re just too lazy, maybe they’ll catch themselves.

Equally, take responsibility, if history proves that getting out even if it seems impossible, may be beneficial in some ways if only to get your blood flowing, try your hardest to make it happen and if you cannot do it today, aim for tomorrow. Never give up.

If the people who are in the lives of those suffering from depression and anxiety stand in solidarity and do not give up on them, there will be less feelings of hopelessness and isolation. Patience really can be a virtue, as well as considering that how and when we say things impacts a vulnerable person far more than we might be aware of.

Lastly, if you’re not able to move from the sofa today, don’t berate yourself, you tried, you did your best for today and tomorrow you’ll try again. If you see life as a series of efforts, you will soon see that some of those efforts pay off and you do keep moving, maybe at your own pace but nonetheless a pace. Don’t try to be like others who are not going through what you are going through, it doesn’t mean you are less than it means you are listening to yourself and your needs and being realistic about things. Motivating yourself as much as you can does work, but holding yourself to impossible standards, usually sets up feelings of failure.

We live in a society that reveres being ‘too busy’ and condemns ‘not being busy enough’ but if we see this as shallow advice and find a balance that works for us, instead of guilting ourselves over not being enough we can stop and appreciate our own rhythm. We are after all supposed to be living, not just running through life. Finding our own pace and avoiding the stigma of being judged for being at a different pace, means less guilt all round.

Mental Health Month “Shame”

SHAME

“Shame on anyone who provokes unnecessary shame.”

For those who have never experienced mental health issues, it may be possible to consider a mentally ill person as wallowing lazily in their feelings of elected sadness. This may provoke a feeling of ‘isn’t it a shame?’ a sense that they are wasting their life choosing to act and behave this way.

Many times the mentally ill person will be quizzed;

Do you work out?

Do you eat right?

Do you sleep enough?

Sometimes those quizzes are not kind queries but have the double-headed effect of sounding like criticisms. The implication being; If you worked out (better or more often) if you ate better (your fault) if you slept well (rather than badly, by choice) you’d not be sick.

I go back to my earlier point, barring cigarette smokers, would we say this to someone who told us they suffered from cancer? (And is it even morally right to condemn a cigarette smoker for his/her part in their disease?).

Who the hell do we think we are?

Well … we think we are the well ones, the ones who have the answers to the malady of elected depression and/or mental-illness. We think this because we have no ability to empathize with a different way of feeling, because we have no experience of it ourselves or we do and we ‘got over it’ so we assume everyone else can.

It’s worth noting, there are differing types of mental illness (no shit Sherlock!) and of those, differing degrees and/or cause/effects. By this I mean the following;

If you are raped, you may suffer depression, anxiety, flash-backs and PTSD afterward. If you don’t that doesn’t make you stronger. If you do that doesn’t make you weaker. Those symptoms may go in a short time, they may persist, they may last ages. It will depend upon a myriad of factors, mainly, whether you had a pre-existing mental illness or not.

If you are already anxious and depressed and you are raped, then it stands to reason, it will exacerbate pre-existing symptoms. If you are not anxious and depressed and you are raped, you may have fewer symptoms because you are not adding to an existing list of symptoms. Again, taht doesn’t reflect how strong you are.

See it this way … if you have an auto immune disease like thyroid, you are at higher risk of getting another auto immune disease. That’s because whatever propensity predisposes you to the development of the auto immune disease, makes you vulnerable to others because they work similarly as they have ‘auto immune’ in common.

With mental illness, people with bipolar often experience Borderline Personality Disorder at the same time, and ADHD. People with Depression often experience Anxiety at the same time.

Sounds bad?

The propensity is by no means a death sentence, it’s just like saying if you have red hair you are more likely to get skin cancer than if you have dark skin, but dark skinned people CAN get skin cancer and not every red head does. Propensity is not a certainty as there are other (epigenetic) factors at play as well as our friend CHANCE.

And chance, almost rhymes with choice – bringing us back to the point. Shame is a choice. It’s a choice we as people who experience mental illness can make, to avoid as much as possible, and it’s a choice people who know mentally ill people can make when they deal with them.

You can choose to treat others as you would wish to be treated. The law of karma let’s call it.

Or you can choose to satisify some blood lust within you and make someone else feel very, very bad. Yeah you have that power, you are almost a super hero – not.

Shame is inextricorbly linked with sexual abuse in childhood, rape, molestation, illness, rejection, certain religions, gender, sexuality and other societal conventions that often it appears, seek to remind us we are not good.

As women we are told, we are dirty if we sleep around.

As children we are told, we are perverted if we masturbate.

As loners we are told, we’re weird because we prefer a book to company.

The list goes on. It’s safe to say, it appears a fond past-time of humanity to judge and to shame. And we don’t have to be in 1600’s Salem!

Just because it’s 2017 don’t think this practice has stopped. We can find it in bullying, which incidentally, is the number one cause of teen suicide. We can find it in work-place bullying which owes a distinction because it affects older people and is growing in prevelency world-wide. We can find it in older populations who are ignored, neglected, considered less important and ‘past it’ to be contributors. We can find it in minority groups and ethnic groups, same-sex relationships, gender roles and identity or lack of, and all the shades inbetween.

My grandmother used to say; People don’t like what they can’t understand and they don’t like difference.

So I guess, if you’re left-handed, queer, red-haired, freckled, hazel-eyed and autistic you might feel left out.

Okay so that’s an extreme but how many of us don’t entirely fit in some way?

You only need to be into one thing others aren’t, or not like wearing dresses, or burn instead of tan, or have darker pigment than your other family members, to experience the feeling of shame imposed upon you by a bizzare set of ideals and rules.

In other words it’s modern society or as I like to call it, torture.

Except this didn’t start just recently, it started when we began to communicate with each other (read Vanity Fair the novel if in doubt) we use shame and shaming as a coping mechanism (attack other before we are attacked) a weapon (divide and conquer) and a tool (defeat the others first, win). Society is a battle-field. For the mentally ill they are easy targets, who among us who struggles to get out of bed in the morning can handle much more?

Even when someone doesn’t know it, they can shame others. It is very common place to say things without meaning them in a bad way. Perfectly ‘good’ and kind people can inadvertantly say something that can be taken the wrong way ‘I wish you felt better!’ and pain ensues.

Obviously you don’t want to walk around on tiptoe when talking to someone who is suffering, but at the same time, just as we should be aware of the sensitivity of other subjects we should consider the sensitivity of how we address depression and other mental diseases.

Not everyone who is bipolar is a mass murderer or school shooter

Not everyone who is schizophrenic will kill their parents

Not everyone who is depressed will jump off Golden Gate Bridge

But some may and those tiny minorities are but the extremes. Beneath those few extremes lie shades of grey. The depressed person who cuts themselves, the anorexic who develops heart problems, the BPD who alienates people and ends up alone, the bipolar or cannot read a book, and so it goes on.

Everyone has something. If we remember that, then we can treat mental disease the way it should be treated, as a disease, an illness, but not the sum of a person, only an element of their whole. Something to be conscious of, aware of, sensitive to, without stereotyping the whole.

The best technique in the world? Listen to what a person has to say. You can learn a lot. And by doing this, you afford an opportunity for your friend to speak about things without a feeling of shame or judgement. In the long run this acts much like talk therapy and can be incredibly cathartic as well as a really good way of realizing, mental illness doesn’t define you.

Mental Health Month “You have everything going for you! Why are you still sad?”

One of the most common issues with people suffering from a mental illness that produces depression of some kind (and many do, as well as many diseases whose byproduct can be depression, such as Parkinson’s Disease) is; My life is good, I know that, and everyone else knows it and often they ask me – you have everything going for you, Why are you still sad?

Does the problem seem obvious?

And yet … given how many people are routinely told this BY PEOPLE WHO LOVE THEM there is some disconnect.

Why?

I will tell you, someone I was close to used to say this all the time about ‘other’ depressed people but never myself. It became obvious if I were not me, they would be saying it about me, and not saying it, doesn’t mean not thinking it. The rush to judgement expressed by those looking in from the outside can be as damming as any mental illness symptom. It can leave you feeling worthless, ungrateful, evil, wrong-headed, greedy and crazy.

But ask yourself this …

If depression were cured by ‘having everything’ many people who are depressed would not be depressed. After all, whilst we know certain economic factors can exacerbate depression (money worries, chronic health issues, chronic poverty) there is nothing to say the rich suffer less than the poor. But if the commonly held belief that ‘having everything’ should prevent depression why is anyone with a good life depressed?

Quite simply because depression doesn’t owe its existence to circumstance. Circumstance can trigger, evoke, worsen, any mental illness (or physical one for that matter) but it doesn’t always cause it. Again, we have to be mindful that there are varying degrees for everything. You can be temporarily depressed about the loss of a job, you can be medium-term depressed about the loss of a parent, or you can be Dysthymic meaning you have long-term-unremitting depression. Otherwise known as Clinical Depression.

Assuming depression or other mental illness, is not fleeting and circumstance based, then it’s fair to assume, circumstance would have little effect on its ‘cure’

That’s like saying I got cancer from smoking if I quit my cancer will go into remission. Not so easy.

Most people don’t ‘get’ depression, most people develop depression over time, for a multitude of reasons and non-reasons. It doesn’t occur over-night (except in the circumstantial kind) but it can rear its ugly head over night once established. Hence why depressed people are often considered ‘flaky’ because with the best will in the world, the next day you just can’t.

So … why are you still sad? Because if you could do anything to stop being you would and you probably have (done nearly everything) and (clearly) it hasn’t worked sufficiently to ‘cure’ what ails you and turn you into Pippi Longstocking.

Next time someone effectively accuses you of ‘not being happy enough’ (read: Not grateful enough) for your ‘wonderful life’ remind them, depression is not a choice, anxiety is not a choice, doing yoga and appreciating a tree is not going to turn you into a different person over night.

That doesn’t mean change cannot be a positive thing – it goes almost without saying that we know certain life-choices make HUGE impacts on depression/anxiety et al. I could fill a blog JUST on those choices and that’s why I’m not, because there are tons of blogs out there, just google ‘how to cure depression’ and you will find them.

But after you have done all that IF you still feel the way you did before or some semblance of it, do not let others bring you down further by feeling you are an ingrate.

An ingrate is someone who has a fabulous life and doesn’t appreciate it.

A depressed person is someone who (might have a fabulous) life and is unable to fully appreciate it because of their mental illness (but boy do they try!)

Keep trying! One step at a time. We break the stigma by sharing our voices.

Mental Health Month “the invisible mentally ill”

Most people when faced with the knowledge someone is mentally ill says

why don’t you just get some help?

therein lies the rub

this writer can attest, ‘getting help’ isn’t as easy as clicking your red shoes together

In the US today there are large portions of what I term ‘shut-in depressives’ those people who are under-or-un diagnosed as suffering from Major Depressive Disorder. They are typically under-employed/unemployed/self-employed or on a pension. They do not factor into many of our statistics in this country. If we added them, imagine how much the landscape of mental health in this country would change? IE; More sick people than we realized.

Why aren’t they counted?

Many times if you aren’t insured by your full-time job you don’t have access to mental health resources. Even with insurance you are severely restricted to how much you can obtain. Individuals with this coverage often fear being discovered and do not use it, or fear the stigma from doctors who if they see ‘anxiety’ on your medical chart, will literally see any illness you have as being psychosomatic (in your head) so … chest pain? Anxiety. Headaches? Anxiety.

My friend who had headaches and was mentally ill was told, it’s anxiety.

It was a brain tumor.

Secondly; Those who are not full-time employees of a company who still insures their workers (and this is growing daily) has to purchase their own insurance. If you consider the cost of say, one of the lowest plans, at $450 a month, a car payment, plus a $8k deductible that has to be paid out of your pocket before you can begin being covered, how many people working say, part-time or a low to medium wage job can afford that? May as well not have insurance!

Of course if you want to pay out $900 a month like a friend of mine, you get great insurance. $900 will also pay for a rented apartment per month.

Thirdly; Those who choose not to go with the self-pay medical insurance are not irresponsible they are normal working folk who cannot afford to pay that much per month. They rely upon pay-as-you-go services like walk-in-clinics. Such clinics cannot refer you up the chain, so they’re great for a sprain or ant bites, not so good if there’s something seriously wrong.

Forth; The ER. The USA has seen huge numbers of people coming into local ER’s with mental health problems, they are second to major car accidents seen at ER’s and typically include the homeless, the low-income, the undocumented, and students. This is a short-term solution. If you are having a manic episode they will pump you full of pills, give you a script, a few lists of people you can follow-up with and send you on your way after a 3 day hold. Given that most state-run hospitals for mental illness were closed in favor of ‘care in the community’ more mentally ill people can be found in jail and prison than anywhere else. Second to that, the streets.

But what we do not consider, are the numbers of invisible mentally ill who fall through the cracks and defy the stereotypes. I will call those people high-functioning mentally ill, by this I do not mean they are ‘better’ than the mentally ill man on the street, but they are able to cover their mental illness a little more, and ‘act’ more functioning. This is the same as a high-functioning alcoholic, and it does in no way suggest those who are not, are weaker.

The high-functioning depressive is typically older. We hear a lot about teen depression because of the higher rates of suicide upon early diagnosis among teens. There are more resources for teens and young people than middle-aged brackets because the two age groups highest for suicide are the very young and the very old.

Where does that leave the 30-year-old mother suffering from postpartum depression or the 35-year-old man who is living in the back of his parents garden in a trailer or the 45-year-old wife who drinks during the day to cope?

The invisible and the high-functioning (because both are not mutually exclusive) walk among us. Typically if you ask them how they are doing they will say ‘fine’ and you will know they do not mean it but you will not ask them more and they will know they do not mean it and will not offer more. Why? Because unlike at 16 when you trust the world to want to listen, a few years down the road you get it, nobody wants to know.

And it’s not just that nobody wants to know about depression it’s that nobody wants to know a depressive, or be friends with a depressive, or be married to a depressive, or date a depressive, or hang out with a depressive.

Does that sound harsh? Do you feel the need to defend?

It’s a harsh truth because if you asked anyone, yourself included, would you rather be friends with someone who is depressive or not, most people statistically check the ‘not’ box. Does that mean if you are dating someone who reveals they are depressed you will automatically dump them? No because you are invested and loyal. But if you went on a dating site, would you choose the profile of someone who says they are depressed most of the time? A few will say yes, and mean it, but the majority, will not.

And that’s the crux of it. It’s a circular self-fulfilling prophecy.

The depressed person – puts off the non-depressed – by their sense of isolation and loneliness – and becomes more lonely and isolated because their depression causes others to avoid them.

So feeling isolated breeds more isolation in effect.

And they still say … snap out of it (like anyone who feels this way, is choosing that for a fun buzz)

Now, to be fair, isn’t it understandable and isn’t it unfair to expect people who are not depressed to ‘friend a depressive’ and be responsible for cheering them up? Sure. But that’s not what a depressed person needs. They know their partner, sister, mom, aunt cannot ‘cheer them up’ because it doesn’t work like that, and neither do magic wands.

What a depressed person wants is the same as what everyone else wants. They want to be accepted for who they are, they want to be respected, they want to be liked, they want to be loved.

But on the other hand they are battling feelings of isolation, alienation, despair, panic, anxiety, fear, nightmares, terror, self-hate, phobias, sensitivity and paranoia.

You may say, well if someone is paranoid then how am I supposed to help them?

Again, it’s not your job to ‘help’ it’s your role if you choose, to be in their life, just like you would anyone else.

For most this is a difficult chore. They find it hard when the depressed person bails on them because they cannot get out of bed, when they have a melt down for no apparent reason, when they are quiet and not talkative, when nothing they do seems to make them happy.

Oh happiness, the illusive demon for the depressed, always out of reach.

Or in the case of the bipolar, there, gone, there, gone, there, gone.

No depressed person or mentally ill person chooses their burden, and yet, the world is intolerant of their disease in a way that is unique to mental illness.

The next question has to be … why? We’ll deal with that in a future post.

So the bottom line is – among us today are many who are invisible to mental health services (of which there are precious few). They are not poor enough for the very lowest income options, they are not well off enough to realistically afford their own insurance, coverage or get a job that will provide that, and as America was founded on the work ethic and our health care was tied to our ability to work this was a problem that bore the need for alternatives, which we now have, but they are so expensive it defeats the point.

Where does the stay at home mom or stay at home wife, or part-time-worker with depression go to get help and treatment that is reliable, cost-effect, consistent and long enough in duration to have any effect?

Having lived in several countries I am in a position to attest, it’s not that much better in other countries. There are more services literally speaking in countries with socialized healthcare but they are so full as to be practically redundant for the complex needs of their societies. I have yet to find a model I would use to base future health care ideals upon.

Then of course you have countries like India, China, Russia, that have a mixed-bag in terms of their approaches to the issue of mental health. For some, it’s almost akin to a crime, for others, admitting it will effectively condemn you to forced inadequate treatments and large-scale stigmatization (more on stigma and shame in future posts) and others socially encourage the condemnation of the mentally ill so that it’s not even discussed and acknowledged.

So as a whole, when we look at all the countries that make up our planet, we are failing to help those who have mental illness, really, really failing. And worst still, there are those among us, who we don’t even know are suffering, who have nowhere to turn, and effectively subsist rather than exist.

You can see them if you look close enough. But most of us don’t want to, or are too ‘busy’ to care. With everything in our ever-busy lives, when do we have time? The only ones who may really try to do something, are going to be our nearest and dearest and for many depressed people there are no nearest and dearest.

What if you are alone more or less and you are mentally ill and you don’t have money, where do you go?

Posing this question to a mentally ill person in the midst of a crisis they are likely as not to say, I’d just give up and take my own life.

Next time you judge someone for being suicidal, consider, have we left many other options for them?