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 “Military secrets”

It struck me during a normal day working at a Rape Crisis Center when I got a call from a young woman who was a recent recruit stationed at a local military base. She told me she had reported being raped by her supervisor, it was dismissed and she was told to drop it or lose her military standing and be dishonorably discharged. She didn’t know where to turn.

I ended up seeing her for over a year, during which time we tried to find out how she could circumvent the military ‘establishment’ and obtain some fair treatment with regards to her sexual assault. Sadly we were not successful and her only recourse was to come see me privately and in secret for fear of people finding out in the military. Her rapist was never prosecuted. Some years later a large national scandal erupted concerning the number of new recruits who were being raped and sexually assaulted en mass on US military training bases and how they were being covered up.

This is one way joining the military can provoke a mental health crisis.

A friend’s brother signed up for the Army at 18 and was deployed overseas to Afghanistan. He came back the only survivor of his platoon, injured but relatively physically well, with crushing PTSD. He developed chronic insomnia, anxiety, clinical depression and had a host of issues that had never existed before, among them, survivors guilt. When he sought help through his local VA he was told he had not served long enough to qualify for many things and his only option was a crowded PTSD group for men, he went a couple of times, there was never enough time to talk about things individually and the anger and tension in the room was overwhelming. He never went back and his VA psychiatrist loaded him up on five medications instead. A couple of years ago another scandal rocked the VA for the over-dosing of soldiers and military personnel of medication for mental health issues, with little therapy or other options being given.

I read about a young man who committed suicide after returning from his deployment upon finding his wife had left him for someone else, and being isolated and unable to re-adjust back into society after being ‘in’ so long. He felt he had nothing to live for, and whilst he did have some old buddies from the tours he did, they were scattered. His isolation and PTSD was untreated and eventually he took his own life. Afterward everyone lamented that more had not been done but nobody thought about that when he was alive. The paltry mental health resources through his local VA which was miles away, were insufficient and outdated. Again, excessive quantities of medication was the norm.

This is the reality of mental health for so many of our soldiers and military who return from dangerous tours and find little by way of mental health support in their communities. The bottom line being, we can’t afford it. Yet, the VA manages to afford many other things, so it is more likely that the priority as is the case world-wide, is not on mental health, despite every published known statistic pointing to the relationship between suicide, illness of all kinds and violence and an inadequate treatment of PTSD and other mental health concerns.

Why don’t we fund mental health?

For those in the military this is crucial because they are being used up and spat out only to be over-medicated and forgotten. Young men who have lost limbs and vigor, get extensive physical rehab but next to none by way of mental rehab. Who doesn’t know that if you lose a limb you will need as much mental as physical ‘work’ to get better? What of the VA and their priorities? Happy to dispense medication or operate, but when it’s a malady of the mind, unable to offer further options? Whilst the VA can be a life-saver it is woefully inadequate as a mental health provider.

The chain reaction of this neglect trickles down. Higher rates of divorce, poverty, disability, inability to work, drug-use, alcoholism, spouse abuse, violence, crime, the list goes on.

If we worked at the source of the issue we would not have to spend most of our time trying to chase the consequences. If you solve the problem to begin with, things would not escalate. How much does it really take to offer better mental health services to our returning forces? Apparently this is not a priority, for counselors regularly apply and are turned away, either because they do not fit the narrow qualifications set out by the VA or they are not hiring, despite a burgeoning need! Psychiatrists see so many VA patients in a day they are overwhelmed and unable to be truly responsive (and responsible!) for each individual. Many times they are done via a satellite link and are not even present in the room.

If you had PTSD would you open up and be candid with a person on a screen?

We exult the bravery of those who join up, and we sing the praises of having a VA system, all well and good, but we need to reinforce this when military return from tours or are impacted by issues that lead to mental health just as much as physical health. Equally, the fears people have when raped, of not getting adequate justice through the military system must change, so that anyone no matter their position and the position of their attacker, can seek justice.

If left unchecked, mental health consequences of rape, PTSD and other mental impacts from working in this field, will go on to have a life-long effect on both the affected individual and their family. Many times we do not realize the family bears the brunt of that person’s return to normalcy. How easy is it to return to normalacy after seeing your platoon shot down and die in front of you? Support for the entire system prevents that system from fracturing, causing a myriad of cracks to appear in a previously sound foundation and this ripple effect can be carried through generations. It goes without saying this applies to both genders, and all law-enforcement as well. More, not less, mental health funding could fix this, but we allocate money elsewhere, thinking mental health is ‘optional’ – try telling that to someone who just saw their friends blown up in front of them.

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 “Rape”

Rape isn’t a subject people talk about very often. Sadly it’s a subject people joke about quite a bit.

The first time I heard a rape-joke I didn’t get it. It was too disgusting to ‘get’ and I am glad I didn’t. Everyone else did though and they all laughed. At the time I didn’t think how someone sitting there who had been raped would feel, but statistics tell us, that likelihood is quite high considering that 80 percent of rape goes unreported and even the reported numbers are staggering.

How a rape joke could hope to be funny, baffles me, but it maybe is more telling of our society as a whole, that we can laugh at true misfortune and tragedy. That’s not gallows humor, that’s just sick.

Rape is never funny. Rape is never something that doesn’t matter. Perhaps if we acted like it mattered more, those who were rape survivors would not be more subject to a plethora of mental illness.

That’s why rape is a subject this Mental Health Month. Because the link between rape and mental illness exists. Rape can among other things, be a cause or contributing cause or exacerbation of; PTSD, Anxiety, Eating Disorders, Depression, Phobias, Suicidality and Suicide, Cutting/Self-Harm and many other conditions.

We’ve talked in earlier posts about how that doesn’t diminish the very real and medical ‘illness’ of mental disorders, and just because an act pushes someone toward feeling a certain way, does not decrease the legitimacy of the illness part of any mental disease. Illness can and is caused by trauma, and there are few things more traumatic to a girl or woman (or boy or man) than rape.

Perhaps though there is one thing worse and that is not being believed, or the act of rape being diminished or ignored.

I hope most of you have watched The Hunting Ground, a documentary on Campus rapes here in America, but if you have not yet, and you have children, know college age kids, or people who work on campuses, it is compulsory viewing not to be missed.

Ultimately the numbers of rapes committed in any situation are underreported, under prosecuted, and not punished. Some judges do not believe a rapist should go to jail. It is often said ‘but he’s such a good boy and he has his entire life ahead of him’ and this stands as a perfectly reasonable explanation for not giving a rapist a harsher sentence.

The other big let-down as far as rape in the legal system goes, is that rape has a statute of limitations and thus, if five years pass and you do not report your rape you are not protected under the law anymore and cannot prosecute your rapist. This is not true for many other crimes including murder, and financial embezzlement. In other words, you can prosecute someone for stealing from you years later, but you cannot prosecute someone for raping you after a certain time period. Great message you’re giving the survivor!

In the interest of fairness, it should be pointed out this exists because the likelihood of having proof after five years is diminished and it is to protect those falsely accused many years later. But that relies upon a significant swath of false accusations and assumes that proof must exist to punish a rape rather than taking the word of the survivor. Therein lies the rub. It is a difficult subject to prosecute when it’s one person’s word against another and historically women have not been believed over men who were upstanding and respected in the community. So if you’re a prostitute and you are raped by a politician, don’t expect anyone to believe you.

Maybe we cannot do enough about this to change it entirely, but speeding up the rate of prosecution cases, ensuring all rape kits are tested (when so many lie untested due to lack of funding) ensuring the survivors are not ‘blamed’ during their legal ordeal, and educating everyone about the low figures of false reporting, may make some difference.

As with anything we can find examples of those who cried wolf, but that is literally true of anything human. It is singular to rape survivors that they are accused of ‘making it up’ as if everyone involved knows of 1000 x cases of liars who pretended they were raped for whatever gain. We should as we do with ‘innocent until proven guilty’ assume someone is likely to be telling the truth when they pluck up the courage and report being raped. If nothing else, something is wrong.

No more so than on campuses across America today, where so many young people are raped and do not report it knowing it will not go anywhere, or do report it and find those who raped them are not penalized sufficiently because they are a star football player. This inequality of punishment needs to be eliminated because what you are effectively saying is, you are not worth as much as the rapist or we do not believe your rape mattered enough to punish this person.

Sometimes I have heard people say ‘she’s too ugly to be raped she must be lying’ and awful things like that. I had one person told by a police officer that because she admitted she was gay, she had obviously chosen to ‘try the other side’ for the night when she was dragged along the street at night and raped by a stranger in an abandoned warehouse. Sure. She wanted it.

Seeing why people who survive rape, are at high risk for some kind of short-term mental illness or at high risk for exacerbating a pre-existing one, is obvious when you look at the details of what someone really goes through. The aftermath of rape is nearly always the worst part. We need to bring our ability to empathize and our compassion to the table and treat all rape cries seriously.

I have worked in two Rape Crisis Centers and the second one I worked in, only prosecuted a handful of cases via the authorities, due to the enormous back-log of DNA testing (rape kits) and the desire of the authorities to plea deal rather than prosecute. Let us not forget a plea deal is often a free pass for a rapist and his offense is often knocked down to a smaller crime that will not indicate to someone looking at his record, that he is a serial rapist. Typically those who rape do so again and again, so if we do not incarcerate them, reeducate them and rehabilitate them if possible they will go out and do it again.

Likewise those who are beyond our help are still let out onto the streets along with paedophiles whom they know will re-offend it’s just a matter of time. How does this happen? How can we justify this?

For those survivors who tell others that they were raped, it is on our shoulders to be as supportive and gentle as possible with someone who confides in us. So often rape is a subject of humor and fun making and there is literally, nothing funny about rape.SAAMP2017 (SM)7

https://merrildsmith.wordpress.com/

https://www.rainn.org/

National Sexual Abuse Hotline: 800-656-HOPE

How to respond to a survivor: https://www.rainn.org/articles/how-respond-survivor

 

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?

Mental Health Month

Fortunately quite a few people are making time for this important subject. Raising awareness.

Before you click off thinking; “I’ve heard this before / I know this already” consider the following;

  1. If you have not suffered from a mental health issue you’re in the minority

2. More people die from mental health influenced factors than anything else

3. There is today more depression in the western hemisphere than ever before and our answer is to medicate using medication that is poorly proven to resolve depression and was only ever meant as a temporary solution, with therapy a rare and restricted ‘luxury’

4. We are cutting back so many mental health resources we now have less than we did in 1970, yes that means we’re going backwards not forward

5. Whilst some mental health issues are better known and understood today than 40 years ago, the terrible truth is … they are judged just as much as they were before people knew more about them and those who suffer from mental illness are often pushed to breaking-point by others who see mental-illnesses as a “choice” even by carelessly chosen words.

Words like – Depression is looking back / anxiety is looking forward / wellness is in the present.

People may say things like ‘snap out of it’ and be well meaning even but imagine saying that to someone who has cancer?

The implied condemnation / judgement / criticism or just put-down in many ‘helpful’ comments furthers the progression of the disease.

Ultimately mental health is seen as a sign of character. If you are mentally ill you have a weak character. If you are not mentally ill you have a strong character. Follow the progression of that.

Strength does not come into whether someone is mentally ill or not, any more than if someone has breast cancer. But like blaming a smoker for their lung cancer, most people see mental illness as something that someone can change ‘if they just tried’ and more of a character flaw, a negativity, a bad attitude, than a crippling, life-reducing disease.

Still think we don’t need to talk about mental illness?