Tuesday, July 21, 2015

And Now For Something Completely Different...and Serious?

A good while back, a very courageous friend of mine, Kendra Thomas, posted a call to action on Facebook for a change in the national discourse on mental illness. In it, she admitted to having depression and encouraged anyone feeling similarly to seek out help. I greatly respected her willingness to share her struggles, and agree that the only way to reduce the stigma is to demonstrate that mental illness is prevalent and treatable. However, the discussion didn’t continue much after her passionate request, and I think it’s important that it does in some form or another. Considering Robin Williams would have turned 64 today if we had not lost the comedic juggernaut to his own demons, I thought now was a good time to humbly share my attempt to change the conversation.

When I was 18 years old, a boy I knew...let’s call him Carl...committed suicide. It was strange for me, as I never knew Carl very well beyond having classes together and the odd social run-in. But he and I attended the same schools for most of our lives and somehow ended up with a similar social group in college, so I felt obligated to inform those people who wouldn’t otherwise know from Facebook or word of mouth. It was unsettling, to say the least. Having an extremely intimate and uncomfortable conversation about someone I really didn’t know all that well.

“So I don’t really know how to say this…Carl committed suicide today.”

“What?? But I knew that guy. Was he really that depressed?”

People can be arrogant like that. We think we know how the world works. We think we know what everyone else is thinking, and we get upset when it turns out we are wrong.

I know about that aversion to the unknown more than most. I am one of an estimated 6.8 million Americans with Generalized Anxiety Disorder (GAD). It’s a pretty broadly defined mood disorder, so let me be more specific about some of my individual symptoms...I exhibit an extremely low tolerance of uncertainty, high looming vulnerability to threat (basically extreme impatience), inappropriate use of abstract linguistic processing (avoidance of emotion by failing to process threatening stimuli thoroughly), and a tendency to catastrophize pretty much anything you let me think about for long enough, among others. Sprinkle a little bit of classic social anxiety on there for good measure and, bam! You have a woman in her mid-twenties who can go from perfectly happy to a sobbing wreck downing whiskey at 11:00 am and blubbering about how an awkward conversation last week is evidence she’s going to die alone, in a matter of minutes.

Don’t believe me? Ask my sister, Lindsay. Since I can remember, she’s served as my shrink. Before my actual diagnosis, we would go through all sorts of theories about what might be causing my struggles with getting through the day...That it was the type of people I hung out with. That I was overly introverted. That I was just one of those people who worried a lot, and I could snap out of it if I just gave it some effort. But I didn’t, because honestly (and I do admit this sheepishly…) it kind of made me feel more prepared than everyone else. Since I was always worrying about stuff, I’d obviously be ready for it, right? Those silly people driving to work un-petrified by thoughts of how quickly the imaginary cancer already growing in their uterus will kill them...they’ll never see it coming!

Yes, many of the people you know are currently depressed, or anxious, or obsessive-compulsive, or whatever else. You may be aware of that fact or you may not. They may not even be fully aware themselves. But waiting to ask the question until after the fact is to ignore the tragic reality that someone finally gave into whatever torment you were unaware of.

“Carl committed suicide today.”

“What a fucking coward. I’m sorry. But how could he do that to his family?”

I have no idea for how long I’ve been anxious to the degree of a diagnosable disorder. Most people don’t. In fact, it’s thought that most GAD-having people don’t seek help for it and the number of cases are much higher than just ~2% of the U.S. population. At any rate, I never thought I needed help, because I never thought I had a problem that needed fixing. What I needed instead was to get over my worries and get out of my own head. Everyone else did it every day of their lives, what the hell was so wrong with me? I’ve led a decently easy life without too much hardship or trauma. But I still found myself utterly exhausted by everyday things like...going shopping, or having a job interview. I felt weak and pathetic. Just the thought of going to a dinner with friends would make my hands shake while I fretted over every possible scenario...that is if the anxiety hadn’t paralyzed me into just cancelling. Every time I was told “DUDE you freak out over everything. Just stop worrying. It’s going to turn out all right,” I would revert into what I like to call a “worry spiral,” over why I couldn’t seem to get the hang of it.

That’s right. Sometimes I worry about worrying. Ever do that? It’s a fun lil circle jerk to work through, ending in some really colorful shades of self-loathing.

My point is, I thought seeking help meant admitting I failed. It meant admitting I was worse than everyone else at...living. I felt the courageous thing to do was to suck it up. It took the people I loved the most in the world telling me they were unable to understand my emotions and felt helpless to support me to make me really challenge my idea of what failure meant.

Perhaps instead of judging one’s actions as cowardice, we should ask how they define it, and why? Ask what could motivate a person to act in that way and, if you haven’t, be grateful that you yourself have yet to be forced to such extremes.

“Carl committed suicide today.”

“Huh, well I guess that’s one way to get attention.”

This kind of victim-blaming is the reason there is almost an entire year gap between Kendra’s original post and this one. I thought people would assume I was looking for pity and miss my overall message. But the fear of coming across as a narcissist is, to me, the lesser evil than continuing to ignore mental health until it causes another tragedy in the public eye. If you are of the opinion that I wrote this for my own ego, then that is your prerogative.

I have met several people who have claimed to have anxiety over the years. I also harbor doubts that a very small number of those individuals may be using the term anxiety to excuse poor behavior and illicit sympathy. However, I am not a mind-reader. I have no way of knowing what motivates a person to share details of their mental state. All I know is that if more people are honest about theirs, those crying out for attention will be drowned out in the conversation. It’s estimated that one-third of the population has some sort of mood disorder...with that many people discussing it, the novelty of having it might wear off.

We have all encountered people who fake all sorts of issues to gain attention. There has even been people who went so far as to create online personas with thousands of followers supporting their fight against cancer while they remained perfectly healthy. But if someone told you they had cancer, would you doubt them because there’s a small chance they wanted to martyr themselves?

“Carl committed suicide today.”

“Holy shit, I didn’t know he was depressed. Shame he didn’t even try to get help.”

The reason I took the time earlier to explain some of my individual symptoms is because mood disorders are muddled. It’s not like a virus or bacteria, where an outside pathogen infects you. You can have multiple disorders with varying levels of intensity, or just exhibit a little more social anxiety than the normal person. Each disorder is really just a spectrum of symptoms that have reached a degree of severity warranting a “disorder,” based on how your mind is hard-wired to work. A treatment that works for one person may or may not work for the next five, even if those people have the same disorder.

One anxious acquaintance of mine exhibits it severely enough to warrant daily medication and weekly therapy appointments. Another has an emergency stash of benzodiazepines to calm him down only in the event of a panic attack, but prefers meditation and deep breathing for every-day coping. One person saw a therapist for only a brief stint until they identified a good medication schedule for her. Another went to a therapist and never returned after an incredibly negative experience, but still reads credible literature on the subject for self-education. I myself see a cognitive-behavioral therapist occasionally and sometimes participate in group sessions, but don’t have any prescriptions. For me, it has proven by far the most effective coping method. For someone else, it might exacerbate their disorder.

Seeking out meaningful help for mental illness requires much more thought than scheduling a doctor’s appointment. It requires humility to admit needing help, funds to afford it, sincere self-reflection to choose a method that suits your needs, determination to try a different route should the first not work, and a willingness to learn some of the uglier things about yourself. On top of that, no one wants to be the crazy person who has to go to the shrink. I will admit I’ve come up with various reasons to leave work for my appointments for fear my coworkers might think I’m unstable or deranged. Yes, that’s also a symptom of my social anxiety, but I do think this enters into the problem. People who feel marginalized by their disorder might not even admit to having it, much less seek out meaningful and effective treatment.

Perhaps if we stop prescribing simple “help” to those with mental disorders and instead offer a brainstorm of the various methods, taking that first step to wellness won’t seem so daunting.

I will never know why Carl decided to kill himself that day, but my friends’ reactions of disbelief, shock, and awe speak loudly to one issue: mental health is a taboo. One that we are so averse to talking about in everyday life (with the exception of caricatured psychiatrists and lunatics in entertainment), that we continue to be rocked by the tragedies that result from its mistreatment, no matter how numerous. Mental disorders can be very different to treat than some infectious diseases, but the rhetoric we use should not differentiate between the two. I can only hope that this has encouraged someone to think and speak differently about mental health, because it will remain destructive as long as we refuse to change our conception of it.

I urge you, if you yourself or anyone you know has shown signs of mental distress, to please start looking into treatment options. Whether that means simply reading about various disorders, trying homeopathic remedies, or even seeking out a therapist, that first small step can make a huge difference months down the line. My loved ones can attest to the changes I’ve gone through since finding a treatment method that worked for me. No one has a chance of improving if they don’t take action. The National Suicide Prevention Line is available 24/7 at 1-800-273-8255 to anyone who may be having suicidal thoughts, and SAMHSA has a line for treatment referral and general mental health information from 8 am to 8 pm M-F at 1-877-726-4727. Be well, my friends. And be good to each other.