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.

 

Mental Health Month “Separating Depressive symptoms from realistic opinions on humanity”

That’s a long title isn’t it? What does it mean?

Philosophers have long quipped that (wo)man’s search for meaning often consists of some degree of navel-gazing and introspection as well as consideration of the greater-meaning of life, including what is positive, negative, realistic and objective versus subjective.

The nuances of each of those, are complex within themselves, can we ever just give a straight and easy answer? Probably not. And because of that, it’s not easy to simply say, someone who has depressive symptoms is not equally influenced by, their world-view which is not always ‘tainted’ by the depression.

In other words, you may be depressed but even if you were not, you may naturally hold or possess some perspectives that could be considered more on the scale of depression than say, the reverse. In other words (lost yet?!) some of our personality is shaped by how we view the world and this can shape how mental illness influences and impacts us.

See it mathematically. If Subject A has a negative world view and also gets depression, which came first, the chicken (world view) or the egg (depression)?

Equally, if Subject A has a realistic world view and also gets depression does that mean being realistic can lead to more likelihood of depression than being say, optimistic?

The reason this matters is – many times those who depression are told the ‘cure’ lies in their perspective. Irrespective of any other considerations such as biological depression, DNA tendencies towards depression, situational depression, etc, the way they perceive the world influences the degree to which they experience depression.

This is true.

But doesn’t that translate into; It’s a choice. It is thus your choice if you do not ‘choose’ to avoid things that may exacerbate or fuel your depression.

This is also true.

So in effect am I supporting the idea depression is a choice and thus, someone’s ‘fault’ if they are depressed?

No.

But isn’t that a contradiction?

It’s not a contradiction because whilst we ARE responsible for what we do with our symptoms and how we perceive things and we know how we perceive things has a knock-on-effect, this is but one element of a larger picture. The larger picture is depression is not simply based upon our perspective of the world nor is our perspective the only cause or effect.

Additionally it is a misnomer to believe positive people never experience depression, negative people always experience depression and realistic people should be less realistic if they want to alleviate their depression symptoms. Whilst there is a relationship between personal perspective and outlook the two are not mutually exclusive, and play only one part in a more complex series of developments leading to depression. It also as stated in earlier posts, depends upon the degree of your depression, the type and the causal factors that vary from person to person, situation to situation.

THAT is why when the media talks about depression they get it so wrong, because they generalize! It’s like trying to talk for every person of color by lumping them all in together! Doesn’t work!

Typically positive thinking is beneficial. But sometimes if you push yourself to be more positive you end up becoming more depressed because you are being ingenious to how you really see the world and you are putting a guilt and pressure on yourself to be someone you are not. One side does not fit all. The way we see the world varies greatly and there is not universal ‘fix’ for depression and that includes positive thinking.

IF positive thinking helps you – emphasis it. IF realistic thinking helps you – go with that instead. For some being too positive feels ingenuous.

Negative thinking is natural but not terribly useful, we all know that. To deny it ever exists puts a lot of pressure upon us to avoid it, sometimes leading to anxiety and feelings of failure. Better to be realistic and admit, if you feel negative, work through it, try to see the other side, and re-balance yourself. Accept that sometimes no matter what you do you may not feel as positive as you would like and you may succumb to negativity for a while. Just so long as you know, there is nowhere to go but down with continual negativity.

That said, sometimes things happen that are negative and not admitting this can be almost like trying believe something you know is not true.

Realistic thinking means accepting bad things happen, not everything is good, you cannot be optimistic all the time and it’s okay if you are not.

Realistic thinking also means you balance the FACTS and you may at times seem negative whereupon you are actually being honest and realistic. Having lived in societies where this was du rigor I was used to that, but moving to America I noticed an emphasis on positive thinking and almost a SHAMING of those who were either realistic or negative. In my humble estimate this may play a part in the increase of depression.

If you live in a society that is intolerant of realistic or negative thinking at almost any cost, and emphasizes and highlights positive thinking you may feel there is something very wrong with you if you do not share that perspective.

I would argue, there is nothing wrong with you and realism should be your first point of call because you are being honest. Lying to yourself either by being too negative or conversely too positive, can have unintended consequences, and whilst aiming high and being positive has its benefits, it does not apply to everyone in every situation.

Case in point, kids today are all given high grades because nobody is allowed to fail. Yet as we know, failure teaches us some valuable lessons. We can take things to extremes and miss the truth of a situation by trying to avoid anything that doesn’t feel ‘good’ yet we learn just as much by trial and error as by positive affirmation and encouragement.

Balance is all.

Next time someone says you are a ‘Debbie Downer’ for being realistic, remind them of this.

Equally, be aware when your negativity sends you into a tail-spin and pull yourself out and re-balance to a more realistic perspective by writing out a list of how you feel versus what you know to be the truth. The key is to try to get how you feel as close to the truth as possible.

Example:

Truth – I am not a loser.

Feeling – I feel like a loser.

Outcome – We can feel like something but without proof it is true, and with evidence to the contrary, this is a feeling stemming from low-self-esteem and maybe an off mood, that can be remedied by realizing how we feel is not always what we are. Equally, define ‘loser’ and critique the ‘need’ to be more than we feel we are.

Living in today’s world with knowledge of history and current events, it’s hard not to at times feel despairing, afraid, frustrated, beyond hope, etc. That is REALISTIC. When we let that bring us down to the abyss that is when negativity has us by the throat. When we dismiss it and look to only enjoy life, that may be dismissing the truth. Sometimes we do have a responsibility to be truthful EVEN if we are going to consider things that do not make us happy. Living hedonistically without care to the world, isn’t realistic, isn’t an answer to depression and does mean we are denying our responsibility to the world at large.

For someone who suffers from depression it can be a natural desire to ‘self-comfort’ by avoiding hard things. Who can blame anyone who has been depressed from wishing to avoid hard things? To ‘not go there’ anymore? But that’s taking things to an extreme. We all must face hard things, in doing so, we learn we can cope, and we also contribute and make things better for others. Running away from that, doesn’t help us evolve and learn coping methods and it means eventually it will catch up with us. Next time you want to run away from something hard, this is worthwhile considering, as a practice run whereby you learn you can handle more than you realize and help others in the process.