Monthly Archives: June 2015

Racism’s Psychological Toll

Interview by JENNA WORTHAMJUNE 24, 2015

Our screens and feeds are filled with news and images of black Americans dying or being brutalized. A brief and yet still-too-long list: Trayvon Martin, Tamir Rice, Walter Scott, Eric Garner, Renisha McBride. The image of a white police officer straddling a black teenager on a lawn in McKinney, Tex., had barely faded before we were forced to grapple with the racially motivated shooting in Charleston, S.C.

I’ve had numerous conversations with friends and colleagues who are stressed out by the recent string of events; our anxiety and fear is palpable. A few days ago, a friend sent a text message that read, “I’m honestly terrified this will happen to us or someone we know.” Twitter and Facebook are teeming with anguish, and within my own social network (which admittedly consists largely of writers, academics and activists), I’ve seen several ad hoc databases of clinics and counselors crop up to help those struggling to cope. Instagram and Twitter have become a means to circulate information about yoga, meditation and holistic treatment services for African-Americans worn down by the barrage of reports about black deaths and police brutality, and I’ve been invited to several small gatherings dedicated to discussing these events. A handful of friends recently took off for Morocco for a few months with the explicit goal of escaping the psychic weight of life in America.

It was against this backdrop that I first encountered the research of Monnica Williams, a psychologist, professor and the director of the University of Louisville’s Center for Mental Health Disparities. Several years ago, Williams treated a “high-functioning patient, with two master’s degrees and a job at a company that anyone would recognize.” The woman, who was African-American, had been devastated by racial harassment by a director within her company. Williams recalls being stunned by how drastically her patient’s condition deteriorated as a result of the treatment. “She completely withdrew and was suffering from extreme emotional anxiety,” she told me. “And that’s what made me say, ‘Wow, we have to focus on this.’ ”

In a 2013 Psychology Today article, Williams wrote that “much research has been conducted on the social, economic and political effects of racism, but little research recognizes the psychological effects of racism on people of color.” Williams now studies the link between racism and post-traumatic stress disorder, which is known as race-based traumatic stress injury, or the emotional distress a person may feel after encountering racial harassment or hostility. Although much of Williams’s work focuses on individuals who have been directly targeted by racial discrimination or aggression, she says race-based stress reactions can be triggered by events that are experienced vicariously, or externally, through a third-party — like social media or national news events. She argues that racism should be included as a cause of PTSD in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (D.S.M.).

Williams is in the process of opening a clinical program that will exclusively treat race-based stress and trauma, in a predominantly black neighborhood in Louisville. Shortly after the Charleston shooting, I called Williams to discuss her work; what follows is a lightly edited and condensed transcript of our conversation.

What is race-based stress and trauma?

It’s a natural byproduct of the types of experiences that minorities have to deal with on a regular basis. I would argue that it is pathological, which means it is a disorder that we can assess and treat. To me, that means these are symptoms that are a diagnosable disorder that require a clinical intervention. It goes largely unrecognized in most people, and that’s based on my experience as a clinician.

What are the symptoms?

Depression, intrusion (the inability to get the thoughts about what happened out of one’s mind), vigilance (an inability to sleep, out of fear of danger), anger, loss of appetite, apathy and avoidance symptoms and emotional numbing. My training and study has been on post-traumatic stress disorder for a long time, and the two look very much alike.

Over the weekend, I received several distressing emails and texts from friends who were suffering from feelings of anxiety and depression. Do you think we should all be in treatment?

I think everyone could benefit from psychotherapy, but I think just talking to someone and processing the feelings can be very effective. It doesn’t have to be with a therapist; it could be with a pastor, family, friends and people who understand it and aren’t going to make it worse by telling you to stop complaining.

What do you think about the #selfcare hashtags on social media and the role of “Black Twitter” as resources for people who may not have the resources they need to help process this? Are online interactions like that more meaningful than they initially might seem?

Online communities can be a great source of support, of course — with the caveat that even just one hater can be stressful for everyone, and that’s the danger of it. But if you don’t have a friend or a family member, just find someone who is sensitive and understanding and can deal with racial issues.

In our initial email about the ripple effects of the murders in Charleston, you used the phrase “vicarious trauma.” What does that mean?

Because the African-American community has such a long history of pervasive discrimination, something that impacts someone many miles away can sometimes impact all of us. That’s what I mean by vicarious traumatization.
Is racial trauma widely recognized as a legitimate disorder?

The trauma of events like this is not formally recognized in the D.S.M. It talks about different types of trauma and stress-related ailments, but it doesn’t say that race trauma can be a factor or a trigger for these problems. Psychiatrists, unless they’ve had some training or personal experience with this, are not going to know to look for it and aren’t going to understand it when they see it. In order for it to be recognized, we have to get a good body of scientific research, a lot of publications in reputable peer-reviewed journals. Right now, there’s only been a few. And we need to produce more.

On your blog, you chronicled the experience of a woman who encounters a therapist who dismisses her fears about racism. Is one barrier to treatment getting the medical community to acknowledge that racism exists?

Yes. A lot of people in the medical community live very privileged lives, so racism isn’t a reality to them. When someone comes in and talks to them, it might sound like a fairy tale, rather than a real daily struggle that people are dealing with. Research shows that African-Americans, for example, are optimistic when they start therapy, but within a few sessions feel less optimistic and have high early dropout rates. It could be that clinicians don’t know how to address their problems, or they may even be saying things that are subtly racist that may drive their clients away. If the patient feels misunderstood or even insulted by the therapist and they don’t go back and get help, they end up suffering for years or even the rest of their lives for something that is very treatable.

Is there a recommended model for treatment?

We have great treatments that are empirically supported for trauma, but the racial piece hasn’t really been studied very well. That’s no easy task, because when we write these articles, they go to journals, where an editor looks at it and decides if it’s worthy and applicable to go in the journal. And then it goes to reviewers who decide if it’s a worthy and applicable topic.

Why has it taken so long to get momentum?

If you think about it, they weren’t even letting black people get Ph.D.s 30 years ago in a lot of places. Ethnic minority researchers are the ones who are carrying the torch, by and large. We’re only to the place now where we have enough researchers to do the work. And there’s so much work that needs to be done.

African-American Women and Depression By Nia Hamm

Depression is a huge health concern among African Americans — particularly women — but mental health is often stigmatized in the Black community. Although it can impact people from all walks of life, cultural habits and historical experiences can cause depression to be expressed and addressed differently among Black women.

“During slavery you were supposed to be the strong one. You weren’t supposed to speak. You were supposed to just do,” said Esney M. Sharpe, founder and CEO of the Bessie Mae Women’s Health Center in East Orange, N.J., which offers health services for uninsured and underserved women. “…Our moms and our grandmothers always told us to suppress. Just be quiet, chalk it up, get up, dress up, fix your face, put on your best outfit and just keep going,” she said.

Depression affects about 19 million Americans. Data from a study published by the Centers for Disease Control and Prevention found that women (4 percent versus 2.7 percent of men) and African-Americans (4 percent) are significantly more likely to report major depression than Whites (3.1 percent). But the CDC also finds that just 7.6 percent of African-Americans sought treatment for depression compared to 13.6 percent of the general population in 2011.

Because the findings show that women — regardless of race or ethnicity — are more likely than men to experience depression and African-Americans experience depression at higher rates than Whites, then Black women in turn also experience high rates of depression compared to the general population.

It should be noted that despite other studies showing conflicting data that are at odds with these findings, the CDC appears to be more reliable because it is the most recent study of its kind.

Black women are among the most undertreated groups for depression in the nation, which can have serious consequences for the African-American community.

“I’ve tried to commit suicide over 15 times. I have the scars on my arms of wanting to kill myself and not even know why,” said 45-year-old Tracey Hairston, a member of the health center who has bipolar disorder.

A report published by researchers at the University of Wisconsin-Madison found that poverty, parenting, racial and gender discrimination put Black women — particularly low-income Black women — at greater risk for major depressive disorder (MDD).

Depression is not only treated at lower rates in the African-American community, particularly among Black women, but of those who do receive treatment, many don’t receive adequate treatment. Hector M. Gonzalez, Ph.D., and colleagues at Wayne State University, Detroit, found that overall, only about half of Americans diagnosed with major depression in a given year receive treatment for it. But only one-fifth receive treatment consistent with current practice guidelines. African-Americans had some of the lowest rates of use of depression care.

Because Blacks, particularly Black women, experience higher rates of depression than their White female or Black male counterparts but receive lower rates of adequate treatment, they remain one of the most undertreated groups in the United States. Several major reasons account for high rates of depression and low rates of treatment for depression among African American women.

A lack of adequate health care can significantly contribute to low rates of treatment among African-Americans, particularly African-American women. More than 20 percent of Black Americans are uninsured compared to fewer than 12 percent of Whites, according to the Department of Health Human Services.

Diane R. Brown is a professor of health education of behavioral science at the Rutgers School of Public Health and co-author of In and Out of Our Right Minds: The Mental Health of African-American Women. Her research shows a correlation between socioeconomic status and poor physical and mental health.

“There’s a strong relationship between socioeconomic status and health such that people at the lower end, people in poverty tend to have poorer health and tend to have fewer resources … for dealing with the stressors of life,” Brown said.

According to the National Poverty Center, poverty rates for Blacks greatly exceed the national average. And poverty rates are highest for families headed by single women, particularly if they are Black or Hispanic.

Studies show about 72 percent of Black mothers are single, compared to 29 percent for non-Hispanic Whites, 53 percent for Hispanics, 66 percent for American Indian/Alaska native and 17 percent for Asian/Pacific Islander. Since Black women are more likely to be poor, to be unmarried and to parent a child alone, which are all stressors that can contribute to poor mental health, they are also least likely to have adequate insurance.

Because mental health is a taboo subject in the African-American community, Black people are less likely than other groups to even acknowledge it as a serious problem.

Psychologist Lisa Orbe-Austin, who runs a practice with her husband and treats predominantly Black women, said her patients often struggle with distorted images of themselves because of the mischaracterizations they face daily. She said psychologists treating Black women often “… try to help them shed some of these stereotypical experiences to kind of cope with healthier ways and to try to find a more integrated sense of self where they feel like they’re truly authentically themselves.”

Depression can affect anyone, but cultural and gender differences cause African-American women to experience depression differently. Researchers at the National Alliance for Mental Illness (NAMI) find that “African American women tend to reference emotions related to depression as “evil” or “acting out.” They cite research providing evidence of communities holding on to long legacies of secrets, lies and shame originating from slavery.

Avoiding emotions was a survival technique, which has now become a cultural habit for African-Americans and a significant barrier to treatment for depression. As a result, Black women are more likely to deal with the shame many feel about poor mental health and depression in much of the same way by avoiding the emotional toll it takes on them.

Because of the stigma surrounding mental health and depression, there is an extreme lack of knowledge about depression in African-American communities. Researchers at Mental Health America find that African-Americans are more likely to believe depression is “normal.” In fact, in a study commissioned by Mental Health America on depression, 56 percent of Blacks believed that depression was a normal part of aging.

A report published by the National Institute of Health (NIH) examined Black women’s representations and beliefs about mental illness. Researchers cite the low use of mental health services by African-American women and identify stigma as the most significant barrier to seeking mental health services among Blacks.

Not only do a troubling number of African-Americans not understand depression to be a serious medical condition, but the stereotype of the strong Black woman leads many African-American women to believe that they don’t have the luxury or time to experience depression. Some even believe it is only something White people experience.

“When seeking help means showing unacceptable weakness, actual black women, unlike their mythical counterpart, face depression, anxiety, and loneliness,” writes author Melissa Harris-Perry in her book Sister Citizen: Shame, Stereotypes, and Black Women in America.

“Through the ideal of the strong Black woman, African-American women are subject not only to historically rooted racist and sexist characterizations of Black women as a group but also a matrix of unrealistic interracial expectations that construct Black women as unshakable, unassailable and naturally strong.”

African-Americans tend to cope with mental health problems by using informal resources like the church, family, friends, neighbors and coworkers, according to a 2010 study published in Qualitative Health Research. In many cases they seek treatment from ministers and physicians as opposed to mental health professionals. This form of coping can be beneficial for Black women who are uncomfortable with traditional forms of mental health care. But it can also encourage beliefs about stigma surrounding mental health in the Black church.

Orbe-Austin said attitudes and beliefs about mental illness and mental health services in the Black community tend to lean toward the idea that therapy is not a traditional coping mechanism for Blacks.

“Psychotherapy is also somewhat culturally bound,” said Orbe-Austin. “It comes from a particular history that is not a black history. Those of us who are culturally competent try to bring in other experiences, other cultural experiences to our work so that we don’t do it in this culturally bound way.”

The challenge, she said, is educating mental health care practitioners on the cultural beliefs of African-Americans and in turn educating Blacks on the medical benefits mental health services can produce.

“You really want someone to get it so that when you’re trying to function in healthy ways you don’t combat other people’s issues as well,” she said.

One of the greatest barriers to keeping Black women from receiving treatment for depression is a history of discrimination and a deep mistrust of health care institutions in the U.S., which can cause Black women to refuse help when they need it. Research shows that African-American women’s use of mental health services may also be influenced by barriers including, poor quality of health care, (limited access to clinicians that are culturally competent), and cultural matching (limited access to work with minority clinicians).

A history of trauma and victimization experienced by African-Americans has also helped foster a cultural mistrust toward the U.S. health care system. Events like the Tuskegee Experiments are hypothesized to contribute to many Black people’s negative attitudes about health care.

High levels of cultural mistrust have also been linked to a negative stigma of mental illness in the African American community. Mental health professionals cite it as another significant barrier to treatment seeking for African-American women.

Despite the seemingly large challenges Black women face with regard to mental health and depression, they have been able to develop alternative coping techniques to deal with various stressors and depression. These include support systems within families, communities and religious institutions.

“Even though they are facing racism and sexism that they are finding ways to care for themselves and accommodate what they’re faced with from external society and largely through a lot of relationships and support systems that they built for themselves among relatives and among friends. There’s the whole history of African,” said Matthew Johnson, a licensed psychologist in New Jersey and faculty member at John Jay College of Criminal Justice.

“We’re seeing a change,” said Sharpe. “…We now see women have a voice and I think that people are seeing that we are extremely intelligent, smart and that we have the compassion to move and to make things happen a little quicker.”

Mental health professionals hope, with more awareness, attitudes about depression among Black women will shift even more in a positive direction. “I do think our community could use a lot of healing and I do think there’s a lot of potential for psychotherapy in our community,” said Orbe-Austin.

If you have Suicidal Thoughts, Please know that YOUR Life Matters!

I like to post this information in the evening, because that is when most people are alone with their thoughts and can’t see the light at the end of the tunnel. So there have been many days when I have read this message and it saved me. If you need to, please take the next step and reach out to someone. Your life matters.

If you have suicidal thoughts

Suicidal thoughts and behavior are common with some mental illnesses. If you think you may hurt yourself or attempt suicide, get help right away:

Call 911 or your local emergency number immediately.
Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
Reach out to a close friend or loved one.
Contact a minister, spiritual leader or someone in your faith community.
Contact your doctor, other health care provider or mental health specialist.
Suicidal thinking doesn’t get better on its own — so get help.

The Misconceptions About Mental Illness We Need to Unlearn

Eric Ravenscraft
Filed to: PSYCHOLOGY 6/16/15 8:00am

Mental illness isn’t like a sinus infection. You can’t just wait it out or take a pill to make everything go away. Our brains are complex and enigmatic, and mental illness is no different. This leads to a lot of misconceptions that make recovery much harder. Here are a few things you should know, whether you’re a sufferer or not.

Before we talk about misconceptions, it helps to identify just what “mental illness” means. Everyone has stress and difficult emotions from time to time and this is normal. Mental illness, on the other hand, is any condition that makes it difficult to function in daily life. It can affect your relationships, your job, or prevent you from reaching any otherwise attainable goal.

If that sounds like a pretty wide definition, it’s because the human mind is complex. Mental illness can range from anxiety and mood disorders that have a severe and tangible effect on your emotions and motivation, to psychotic disorders like schizophrenia that affect your perceptions or senses with things like delusions or hallucinations. Living with any of these can be debilitating. We rely on our senses, emotions, and perceptions to get us through the day. When any of those fail, it can make life difficult.

I’ve struggled with mental illnesses for decades. Over the years, I’ve had diagnoses ranging from depression to Asperger’s and I’ve encountered a ton of misconceptions. Some are basic things that the general population just hasn’t learned about, while others are deep-seated beliefs that even I have had to un-learn. Here are some of the ones that still seem to stick around.

Misconception: “Mental Health Problems Last Forever”

Doctors, patients, and friends alike that talk about mental illnesses will often tell you it “never really goes away.” They say this both to set expectations (as there is rarely a “cure” in the traditional sense) as well as to help others understand the struggle that those with mental illnesses go through. The problem is, this is often interpreted to mean that the symptoms of mental illness never go away.

If this were true, therapy and treatment would be pointless. In fact, telling someone with a mood disorder like depression that their problems will never go away can sap their already dwindling motivation to try. However, the truth is a bit more encouraging: while we don’t know how to cure mental illness, it’s very possible to treat many types of mental illness to the point that the symptoms can be managed and a person can live a fulfilling, happy life.

For many decades, it was assumed that once a person reached adulthood, their brain would no longer change. As David Hellerstein, MD explains, even as recently as the 80s and 90s, the concept of the brain physically changing over time was given little thought. However, in recent decades, researchers have increasingly discovered that neuroplasticity—which simply means that your brain creates new connections and restructures itself throughout the course of your life—can play a huge part in how your brain develops and changes over time:

In brief, we have realized that ‘neuroplasticity,’ the ongoing remodeling of brain structure and function, occurs throughout life. It can be affected by life experiences, genes, biological agents, and by behavior, as well as by thought patterns. Interestingly, exercise and physical activity in general have a major effect on ‘neurotrophic factors’-chemicals that stimulate the growth and recovery of brain cells.
The concept of neuroplasticity is still a new area of research, but it does give hope to those with mental illness: just because your symptoms are intense and unbearable right now doesn’t mean they always will be. Like many people, I first learned about this idea just a few years ago. It was the first time in decades that it seemed like there was hope for my situation.

It’s still not an easy road, of course, especially for psychotic disorders like schizophrenia that can be much harder to treat. However, over time and with the help of therapy and treatment, your brain can adapt. You might never be “cured”, but it’s still possible that having a mental illness may someday be something that’s only a minor annoyance, rather than a crippling disability that makes it hard to even get out of bed.

Misconception: “Only Violent or Unstable People Have Mental Health Problems”

If you only ever read comic books, you might reasonably be led to the assumption that radiation gives you superpowers. By a similar token, if you only ever watched movies, TV, or the news, you might believe that having a mental illness at best makes you a crippled genius, and at worst a serial killer. Both of these correlations are untrue.

Mental illnesses are, by their very nature, disruptive to a person’s life. However, the way they manifest can vary wildly from person to person. Mental illness is not the only factor that determines how a person behaves and interacts with others. Some depression sufferers internalize their symptoms and can appear perfectly happy on the surface, while others may show their symptoms very obviously. Anxiety can make a person irritable or simply avoid social interactions. Assuming that mental illness makes someone unstable is like assuming a career in engineering causes people to wear polo shirts.

As for the violence stereotype, there’s virtually no evidence to suggest that mental illness and violence have any meaningful correlation. As Dr. Heather Stuart explained in a 2003 paper on the subject of violence and mental health, mental illness is “neither necessary, nor sufficient [to cause] violence.” In other words, having a mental disorder did not inherently make someone violent, nor did being violent indicate that someone had a mental illness.

That’s not to say that there is never any overlap. People with mood and anxiety disorders can still be violent. So can anyone else. If you’re a friend to someone with a mood disorder, you don’t need to worry that they’re going to become violent unless they demonstrate a propensity towards violence. Similarly, you can have an anxiety disorder even if you seem to have your life together. Everyone, regardless of their personality, lifestyle, or background can suffer from a mental illness.

Misconception: “You Can’t Handle Relationships”

Having a mental illness is never ideal, but it also doesn’t mean that you’re unable to take part in normal things like pursuing relationships. Because mental illness can cause stress in any kind of relationship, there’s often pressure to “get yourself together” before you can maintain friendships, work relationships, or romantic endeavors. However, quite the opposite is usually true: isolating from normal relationships can be a hindrance to recovery.

As mental health journalist and schizophrenia sufferer Lisa R. Rhodes explains, having supportive relationships can aid in recovery. Since mental illness affects how you perceive or react to reality, having relationships with people who are able to help you through is a huge asset:

Years of research have shown that having social support is an essential part of recovery in mental illness. Supportive romantic relationships in particular are important for depression, because a good relationship can help bolster someone who’s going through a depressive episode, while a bad relationship can trigger depression or make pre-existing depression worse.
Speaking from personal experience, one of the hardest parts of dealing with depression was that how I perceived the world was frequently wrong. Relying on friends and loved ones to provide outside input helped to counter that perception and keep me grounded. Without that psychological counter-balance, it’s very likely that I would have veered too far towards self-destruction or even suicide. While my illness often took a toll on my relationships (and still does occasionally), they were also crucial to my recovery.

Relationships can certainly be hard for someone with a mental illness. They can also be hard for someone who has a terminal disease, someone with children, people who live long distances apart, or people with red blood who breathe oxygen and live on planet Earth. Relationships aren’t easy. Having a mental illness certainly makes relationships a challenge, but it doesn’t disqualify you from having them.

Misconception: “You Can Just Snap Out of It”

One of the worst and most prevalent misconceptions when it comes to mental illness is the “snap out of it” response. If you’ve ever suffered from a mental illness, you know the drill: you start talking to a friend about your problems. They listen for a while and offer some support, but eventually they start to talk about your attitude towards the problem. “It’s all in your head,” or “Just don’t dwell on it so much,” or “You need to move on.”

The thing is, the inability to “just get over it” is exactly the problem. It’s what separates mental illness from normal, day-to-day stress. Your brain is supposed to be able to filter your emotions and process thoughts rationally, but sometimes it doesn’t. Everyone has problems handling their emotions and could use some encouragement sometimes. What makes mental illness different is that the part of your brain that helps make the jump from discouraged or worried or unmotivated back to normal is malfunctioning. The amazing Hyperbole and a Half blog explains how this concept can be damaging and frustrating for all involved:

But people want to help. So they try harder to make you feel hopeful and positive about the situation. You explain it again, hoping they’ll try a less hope-centric approach, but re-explaining your total inability to experience joy inevitably sounds kind of negative; like maybe you WANT to be depressed. The positivity starts coming out in a spray — a giant, desperate happiness sprinkler pointed directly at your face. And it keeps going like that until you’re having this weird argument where you’re trying to convince the person that you are far too hopeless for hope just so they’ll give up on their optimism crusade and let you go back to feeling bored and lonely by yourself.

And that’s the most frustrating thing about depression. It isn’t always something you can fight back against with hope. It isn’t even something — it’s nothing. And you can’t combat nothing. You can’t fill it up. You can’t cover it. It’s just there, pulling the meaning out of everything. That being the case, all the hopeful, proactive solutions start to sound completely insane in contrast to the scope of the problem.
Having mood or anxiety disorders isn’t just having a particular feeling. It’s losing the ability to feel anything else. Sure, you know that you don’t have to be nervous when meeting new people, but all your brain can think about is how awkward you feel. You can tell yourself not to think about it, but it doesn’t work. Put another way, if you could just “get over it,” you wouldn’t have a mental illness.

This misconception is particularly insidious because people with mental illness succumb to it too. If everyone’s telling you to just feel differently, but you can’t, then you start to stress over why you can’t do it. Your inability to control your anxiety makes you more anxious. You can’t stop yourself from feeling hopeless, so you feel more hopeless. It’s a terrible cycle and the only way to break it is for both sufferers and supporters to recognize that they need to find an alternative solution.

Misconception: “Treatment Is a Waste of Time”

One of the most damaging misconceptions about mental illness is the idea that going to therapy is waste of time. Much like the previous misconception, this one comes from sufferers who feel hopeless and supporters who feel frustrated alike. Also like the last section, it only serves to get in the way of genuine recovery.

Of all the misconceptions in this article, I personally relate to this one the most. Unfortunately, neuroscience is still a developing field, which means that even mental health professionals may be subject to error, developing science, or the constantly-changing models we use to understand human behavior. If you’re cynical (or if the costs of treatment are too high), it can easily feel like getting help is a waste. Why pay someone hundreds of dollars to listen to you talk when you can vent your woes to your bar buddies for free, right?

The reason this misconception is a problem can be explained by the last one: your bar buddies probably don’t know what they’re talking about. Talk therapy might seem like a waste of time, but you’re not paying to talk. You’re paying to get the experience of someone who understands mental illness better than you (and your friends) do. Like most other services where you hire a professional, you’re paying for expertise.

This process can be very long and involve what feels like a lot of wasted effort. Your first few sessions in talk therapy are likely going to involve a lot of explaining your past. Some treatment methods like Dialectical Behavior Therapy can involve classes on coping mechanisms or strategies to help you deal with emotional flare ups. If your doctor prescribes medication, you may end up having to try multiple types of pills before you find one that works for you to produce the intended effects. And that’s to say nothing of newer types of treatment still being developed.

That’s a lot to handle if you feel like your only problem is getting worried too often. If you’re depressed, the thought of even figuring out what type of therapy to pursue can be overwhelming, much less getting the motivation to step out the door every week to keep an appointment. However, as we established earlier, just trying to “feel better” until you’re cured doesn’t work. Getting help, on the other hand, might. Even a small chance is better than none at all.

My personal journey took nearly twenty years. When I was eight years old, I had a few seizures and was diagnosed with epilepsy, which it turns out I didn’t have. Later the diagnosis changed to Tourette’s Syndrome, then they added ADHD and OCD. Depression got tacked on after that. I’ve been on at least a dozen different medications, I’ve been in residential treatment facilities and special education schools. I’ve tried toughening it out, I’ve tried praying it out, and I’ve tried reprogramming my brain with computers.

There were a million moments where that journey felt pointless. In fact, one could argue that some of my experiences actually made my issues worse. I’d like to write here that getting treatment will definitely help, but I know all too well that’s not always true. Sometimes you try something and it doesn’t work, and I don’t want to give anyone false hope. However, doing nothing was the only thing I ever tried that was guaranteed to accomplish nothing.

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