Homosexuality. Gay. Lesbian. Bisexual. Transgender. Questioning. Asexual.
These are not a mental illness. In 1973 The American Psychiatric Association’s Board of Trustees removed homosexuality from it’s list of diagnoses in the DSM. All major mental health professionals agree with this, that it is not a mental health condition.
However, there are greater levels of mental health problems within this group of individuals. It is not due to their beliefs though. In large part, it is thought to be due to the discrimination and stigma that they face on a daily basis.
When a young person is faced with “coming out” to their parents or peers, and rejected by either, their risk for depression and suicide is quite high. Anxiety and self harm becomes and issue as well. Substance abuse might begin to occur. Abuse – physically and emotionally at home can occur. All of these factors can lead to a decline in mental health and serious mental illness later on in life.
It is important that mental health issues of that are LGBTQ are addressed if they need to be. No, not everyone in this group has them. But when they do occur, they should not be afraid to seek help. And there should be adequate resources to help them.
We should stand behind them to help them get the support they need. All too many times people tell them they need to change, to seek help from church, to pray, even to get “conversion therapy.” I am not here to debate beliefs on this blog and will not do so. I am simply here to discuss that those that are so defeated by the stigma and discrimination due to their own beliefs feel the need to escape life by suicide or self injury or substance abuse – need help. Professional help through counseling, therapy, psychiatry. Friendship and understanding.
I had friends come out in middle school, I had friends come out in high school, I had a lot of friends that were out in college. I am 26 so I knew people that were coming out when we were 12,13 back in 2000 or so. It was hard for them. They were not treated that great. But then, once they came out, a few others did too, and it wasn’t such a big deal. Honestly, in my generation, it really isn’t as big of a deal as it was a long time ago. But it still is a really big deal at the same time. So, if you know someone battling stress, anxiety, self harm, substance abuse, or suicidal thoughts related specifically to this issue – here are some resources.
Some resources are:
GLBT National Hotline: 1-888-843-4564
GLBT National Youth Talkline: 1-800-246-PRIDE (7743)
Online peer-support chat: http://www.glbtnationalhelpcenter.org/chat/index.html
Since my therapy session on Friday morning my anxiety has been absolutely ridiculous. Normally I have somewhat of an on and off low grade general anxiety and a very high social anxiety. Then there is the panic attacks associated with my PTSD when I have a flashback or nightmare or something of that sort. Since Thursday night/Friday morning though, I have had intense anxiety. My heart has stayed at a high rate, I cannot seem to sit still, I actually feel incredibly exhausted from it all, and I am feeling somewhat depressed and have cried off and on.
My therapist told me to go walking as I used to do this quite a bit for my anxiety to get the energy out. I tried to do this on Friday and Saturday. Friday I just broke out into tears about 30 minutes into it. I wasn’t just slowly walking either, I was going in intervals of walking/jogging. But the energy and anxiety just wasn’t leaving me.
I recently changed anxiety medications. But my previous one wasn’t doing anything at all. I am not sure if this new one is making things worse or therapy is just bring up new emotions. I also just came back from the family reunion which was quite difficult for me and I think brought up a lot of memories too.
Getting through this weekend has been incredibly hard. I cannot wait until tomorrow morning when I can call my psychiatrist and beg him to raise this dosage or give me something to get through until the next appointment, or make the appointment earlier. This anxiety is really getting to me! It doesn’t even seem like my coping skills are helping me anymore.
If anyone has any insights into how they deal with anxiety when their meds aren’t working or if they don’t use meds at all, please let me know because I could really use the help.
Stigma. Stigma creates so many barriers for those of us with mental illness. I know it has prevented me from sharing my illness with people, at least when I was first diagnosed. Although that quickly changed. I was in nursing school – and I ended up in the psych hospital —- the same semester we were doing psych clinicals. So, all my fellow students walked in there ready to work with the patients, and I was one of them. I couldn’t hide it anymore. I was so freaked out. I ran to the room and shut the door and refused to come out. It didn’t matter though, my name was up on the board and they had my chart. My whole history!
After that, there was no point in hiding it. I just decided to be open. Of course, I still was in denial at this point and was in and out of the hospital. I had dropped out of school for the semester after my first hospitalization, but still saw my fellow students throughout all my hospitalizations. I was open with them about what was going on with me. They never talked bad about me to my face and I think they were understanding.
Stigma really hurts though. There are two types of stigma:
1. Social stigma – this is the attitudes, beliefs, and behaviors that other individuals direct towards those with mental illness
2. Self stigma – this is when the person with mental illness perceives the discrimination in their own way and internalizes it – leading to poor self esteem, guilt, shame, etc
Because of self stigma and social stigma, those with mental illness avoid treatment for fear of how they will be treated. They do not want to be diagnosed with something that might make them “different” from others. They do not want a diagnosis that will cause others to be scared of them. Many people often think that those with mental illness are “dangerous” when in reality, people with mental illness are more likely to be victims of violence (by someone else or to themselves, i.e. self harm or suicide) than to be violent towards someone else (shooting, murder, all those stories they show on the media, etc).
The only way to get rid of stigma is to continue to educate those around us about mental health and mental illness. People might not want to hear about it. We cannot push people to hear about it. But we can bring it up here and there. We can be honest about our struggles instead of hiding them. If someone asks how we are doing, we can tell them, we can be truthful. We can take off our masks and tell them we have bipolar or ptsd or anxiety or whatever we might have and explain we are having a rough day. We can write to our leaders in government to help expand funding to mental health resources. We can leave brochures at libraries or other public places about support groups. We can make a difference in helping defeat the “bad name” that these disorders have gotten.
There is such a lack of mental health services and even if there are resources available access to them is quite hard. For example, I live in a larger city (Tampa, FL), and there are quite a few psychiatrists and therapists around. Many of them do not accept insurance at all (only self pay), many only take a few insurance plans, and those that do accept most insurance plans have long waiting periods to even get an appointment (3-6 months to get an intake).
What are you supposed to do when you need medication but you cannot get in to see your doctor? Go to a hospital? You aren’t suicidal and you don’t have insurance – but the only way to get your medication is by getting admitted to a psych hospital? And in some areas, they do not even have enough psychiatric beds in hospitals even if you are suicidal, so they simply send you home when you are in danger (sadly, this does happen).
I was lucky enough to live in a town in Indiana for 6 years where I obtained great services. I unfortunately was not functioning well enough to get much help from them, but they provided therapy 2x a week, case management 3x a week, psychiatry 1x a month, a clubhouse that was open 7:30am-3pm, and on call services 24 hours a day. They had their own hospital affiliated with their clinic. When I had insurance they accepted it. When I didn’t have insurance they worked with me for a reduced rate ($11/apt). This was completely unavailable when I moved to Florida though. I left the state hospital in Indiana and moved to Florida with absolutely no services for the most part. I had a 3 month wait for the psychiatrist (luckily it was set up while I was still in the hospital, but I still had 1 month after I moved here). This office was horrible though. My appointment would be at 1pm, but I wouldn’t see the psychiatrist til 5 or 6pm. And this was a regular occurrence – I wouldn’t actually see the psychiatrist until 4-6 hours after my schedule appointment time. I couldn’t handle it and finally scheduled an appointment with another psychiatrist, but it took a 3 month weight, and of course, this one didn’t take my insurance so I am self pay.
There are just far too few mental healthcare professionals today. They are one of the lowest paid specialties in the medical field. With the high cost of medical school, few people choose to go into the field. In many areas, there are only private practices as well and not community mental health clinics. Private practice clinics do not offer many of the services that a community mental health clinic can offer such as case managers, medication management, and most importantly a reduced/sliding scale fee that many people may need.
More attention needs to be focused on increasing resources geared towards mental health. Not simply just creating awareness, but actually doing something about it. Fixing the system. Adding more healthcare providers. Getting people more inspired to go into the field. Adding more psychiatric nurse practioner programs to help aid reducing the time patients have to wait to see someone. Increasing funding for hospitals so that patients are not turned away. If someone goes to a hospital for help, they should not be told that they cannot get it.
This lack of mental health resources needs to be addressed.
I know a lot of us are sick of hearing “Let it Go” from Disney’s movie Frozen. But when you listen to it, it really has some interesting lyrics. I read this article a few weeks ago, and after reading it I decided to actually listen to the lyrics of the song instead of being irritated by the constant playing of it on the radio and kids singing it at the movie theatre and stores. I thought, “Wow! This actually kind of relates to me and my feelings.”
I haven’t seen the movie itself, and hearing the song repeatedly is still a little annoying to me after hearing it so often in the beginning, but I still do enjoy thinking about the song when I feel a little down.
Here is a link to the article. It was written by Nadia Ali, Ph.D. She is a health psychologist on faculty at Emory University’s School of Medicine, in the Department of Human Genetics. She has over 15 years experience providing psychological care with medically ill populations
Having bipolar, ptsd, and borderline personality, along with bad social anxiety causes me to have problems with relationships in my life. So many times in my life I have been involved with people that bring me down. They destroy me. I long so much to be wanted, to be understood, to have someone care about me though that I don’t seem to understand that these people are just making my mental illness worse and they are hurting me.
I have such bad social anxiety that once I do find someone I am comfortable being around, I don’t want to leave that situation even if it is a bad one – be it a friendship or a romantic relationship.
I didn’t grow up in a great environment. I don’t have a great relationship with my parents. I currently talk to them, but I try to set up boundaries around the relationship I have with them because I am not comfortable with them. It took me a long time to learn how to create boundaries with people though. I always use to say “yes” to people. I didn’t know the word “no.” I was a people pleaser as some might say. My friendships were usually one sided — I would always stay up late listening to other peoples problems, but no one would listen to mine. I would always go out of my way to help them go get something, but when I needed something I was left on my own. So many people in my past had hurt me though, that I felt like if I didn’t do these things that I would lose these people who I thought “cared” about me.
Boundaries are a big thing. I didn’t know how to even set them. It took years in counseling for me to understand what boundaries were and how I could implement them into my life. I still have problems with it today, especially with my parents. I feel guilty since they are my family. But they are also toxic to me many times. I have to set boundaries no matter how people are related to me if they are more detrimental to my health than helpful. That is something I have had to learn and am still coming to terms with.
Someone told me one time, “No is a complete sentence. You can just say no. You do not have to add on to it or justify it or create some story. Just answer them with ‘no’.” If you need to set up a boundary with someone and you don’t want to be with them or spend time with them that day, say you cant, tell them no you cant help them out. It is ok. Take care of yourself first.
It is so easy to think about suicide. And then so easy to begin ruminating on it. And for me, it eventually became easy to act on those thoughts. For two years, I was so deeply depressed that my life revolved around my suicidal ideations and even suicide attempts. I would simply lie on my couch, crying and thinking about how to die and how much I wanted to die. I knew why and yet I didn’t know why at the same time. Sometimes it had to do with my bipolar, a chemical imbalance. Some of it had to do with my borderline personality, just if something happened that triggered me to suddenly lose control of my feelings. And other times it just had to do with my PTSD if I was having awful memories and wanted to just get away from them and end my life. It went on for two years though because I didn’t want the help, I didn’t know how to truly accept the help, and in some weird way, I didn’t even think I needed help. I felt like the only help I needed was for someone to help me die.
I had quite a few suicide attempts, but never really did any major damage. I was in the ICU a few times, but only one of those times was it somewhat serious. At the time, I didn’t know if I was happy or sad to be alive. Actually even today I am not sure how I feel about that attempt. Things have gotten much better in my life, but I still suffer with depression because of my mental illness, and so I question if living or dying would be best. I do not think suicide is the answer at all, but as many (not all) people with depression do, suicide still comes up in my mind from time to time.
I really like the saying: “Suicide does not end the chances of life getting worse, Suicide eliminates the chances of it ever getting better.”
People always tell you, “Suicide is a permanent solution to a temporary problem.” Yes yes yes… I know I know. But in my head, my problem is not temporary, so if you say that to me… it doesn’t even sound like a good statement. So I hated when people told me that. And everyone told me that, over and over again.
However, the first statement, that just seemed really eye opening to me. I really never pictured my life getting better, but it still lit up my mind to thinking perhaps it could. So when I think of suicide now, I always tell myself this quote. If I just wait another day and see how that goes. Maybe tomorrow will be better. And I just keep putting it off. Eventually the thought does pass. Eventually I do have a day that is better than the previous day, and the thought somewhat disappears into my brain – until the next chemical imbalance or trigger or flashback. Again, I try to use the same technique of putting off and suicidal actions day after day after day though.
I lost a friend to a drug overdose back in November. It was not a suicide attempt, but she did suffer with depression. It hurt me incredibly bad. Seeing how it affected me and her family and other friends was very eye opening. I never thought about how much it would hurt my family and friends. I really believed in my mind I would make things better for my family and friends. I thought they would believe I was better off dead – that my pain would be gone and so they would forgive me for what I did. That I would no longer be a burden to them and that they would be happy with me gone. But now that I am thinking clearly, on proper medication, in good therapy – I see that this thought process was not true at all. I slip into every once in a while still, but that is how our brains work and we have to fight back.
We will all go back and forth, have good days and bad days, but we can have a good life. I went through 17 hospitalizations between 2011-2013. Fifteen of those being within 1.5 years. Today, while I still struggle, I am stable for the most part and trying to get my life back on track. Much happier, not lying on my couch all day, not crying all the time, and my mind is not obsessed with dying. Life does get better. I never thought I would say that either.
If you, or anyone you know, might be feeling suicidal, call the suicide hotline at: 1-800-273-TALK(8255) or go to http://www.crisischat.org (between 2pm-2am)
Also, talk with your doctor and/or therapist if you have one about how you are feeling, and do not abruptly stop any of your medications without consulting them.
A lot of people tell me I don’t need medicine. This especially happened when I was first diagnosed with depression. “Oh I have been depressed, it will pass. Just don’t worry about things. You have such a good life. You are doing so well in school. I don’t even know why you are depressed.” – they would say. Even today, I get the whole “mind over matter” given to me or “God will heal you, just pray.”
My problem with this is, none of these people have been in my situation. Sure, everyone gets “depressed,” BUT depression is such an overused word now that it has lost its real meaning. In reality, everyone gets “sad.”
According to Merriam-Webster dictionary, depression is defined as: a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way.
According to Merriam-Webster dictionary, sad is defined as: affected with or expressive of grief or unhappiness
So when people say they are depressed, they are not, they are sad. Unless they have been to a doctor and have been diagnosed with a disorder that encompasses depression, they do not understand.
I am not saying that everyone who has a psychiatric diagnosis of something that encompasses depression will need to take medication, because there are a select group of people that can function and learn to function without it. However, many people do need to take medication. For others to put stigma on mental illness and basically encourage them to not take their medication by saying they do need it is dangerous.
I personally have gone on and off medication. I was noncompliant with my medication when I was first diagnosed. I didn’t think I needed it and I didn’t want to take medication the rest of my life. What ensued after every time I stopped taking them was a trip to the ER and then psych hospital for a suicide attempt, a trip to the psych hospital for suicidal ideation, the cops coming to my apartment for welfare checks and then usually bringing me to a psych hospital…and that continued until I was eventually committed to a state hospital where I was forced to take medication. The light bulb went off in my head there, my Aha! moment occurred there though. I was actually doing better! I was feeling better! The medications actually helped me!
It took years and years to find the right combination of meds for me. And for most people it does take that long. It is easy to give up, especially when people are telling you that you don’t need it. If you know that you need them because you are not functioning well though, don’t give up. Continue to use your coping skills and continue to fight to gain your life back. Mental illness is not easy, but you can learn to live with it. And not only live with it, but live a good life with it.
Most importantly, if you ever feel like you want to get off or change medications, for any reason at all, make sure you talk to your doctor about it.
Today, as I start this, I look back on how far I have come in my own recovery. I currently have been diagnosed with Bipolar, PTSD, and Borderline Personality disorder. I have had problems with mental health for as far back as I can remember, but I distinctly remember at the age of 10 feeling the absolute pain of deep pain and feelings of wanting to die. That pain continued to worsen for the years to come. In 2011, while in my junior of college, I completely fell apart though. I had my first of 15 psychiatric hospitalizations that would occur within a two year period and would lead to my commitment in a state hospital. However, that commitment would be the best thing that ever happened to me. I was in an intense treatment program, I had an excellent psychiatrist, psychologist, group therapists, recreational therapists, psychiatric technicians, and made a lot of friends who I actually still talk to. I spent 6 months there and left stable on medications, with a better understanding that I NEEDED to take my medications to feel better. A concept that I failed to really believe before that. Since being out of the state hospital, I have been hospitalized twice, however 2 times in one year is a big improvement for me opposed to 15 times in 2 years, so I feel like I have accomplished a lot, especially since both times I reached out for help opposed to being court ordered on a 72 hour hold.
There were many things that have helped me get to where I am today in addition to the professional support and medications. Most importantly, support groups. I have been involved in NAMI (The National Alliance for Mental Illness) Connection Support Groups since 2011, in 3 different states, that I have lived in. Every time I moved I found a group to attend. It has been integral to my recovery as it helps me connect with others that have similar problems as me and find coping skills, help others, and gain support when I feel I am slipping. Currently, I am going through training to become a facilitator myself and I am very excited to move on to this role! But I will continue to attend one group a week as a participant to ensure I follow through on getting support for myself as well.
That is just a little bit about myself.
More importantly though – Through this blog, I want to express issues related to mental health. Different disorders, coping skills, problems with the mental health system, and other issues.