What I might say about my mental health

If I wrote my own mental health confessional, I would begin by saying I’ve struggled with depression most of my life. I would note that for many years this condition went undiagnosed, but therapy brought to light indications of the illness going back at least to when I was 9 or 10. I guess I would admit that the first time I seriously considered suicide, I was 10.

I would talk about difficult feelings I was having by the fourth and fifth grades and beyond, even up to the present. About making decisions, some more significant than others, that weren’t the best choice, even though on some level I often was aware they weren’t the best when I made them. About feelings of despair and low self-esteem. About difficulties in processing feelings and accessing relationships. About hurts that lingered.

I would include something about the unhelpful things I’ve heard from an early age. One was a bemused “Now, don’t be bitter.” Another, “You’re too sensitive.” How about “we’re not laughing at you; we’re laughing with you” — when I was not laughing? “Snap out of it,” was the commonly suggested cure for people with conditions such as mine. Similar are “get over it” and “suck it up.” One parent once lamented, “I don’t know why you have to be so different.” The other once complained that I was “always miffed about something.”

I might mention but would not describe an incident in early adolescence when I was feeling so bad about myself that I expressed it in a way that engendered anger, making me feel even worse about myself. It left a deep scar. I’ve shared details only with therapists and my spouse. Therapists have said it was an obvious red flag. The first time I shared it with anyone was with my spouse. I became emotional and had trouble getting through it. That may have made it easier to talk about later in therapy.

Adventures in therapy

I would describe the first time I tried therapy and what led to it: During my sophomore year of college, I started noticing I was tired a lot, even for a college student. I continued to feel that way during the summer, the last summer I spent in my childhood home.

A doctor determined it was nothing physical and gently suggested seeing a mental health professional. When I returned to college for fall semester, I jumped through assorted hoops at student health, eventually landing weekly appointments with a psychiatrist.

In hindsight, it’s easy to see that the tiredness was a manifestation of depression, but you never heard much about depression in those days. It was not my diagnosis at that time. The doctor listened to me for 50 minutes each week for most of the school year, asking leading questions but offering few reflections on what I said. I got much more from one session with a college chaplain that summer. He was the first person who ever said to me in all my 21 years, “That must feel bad.”

As I would continue telling my story now, I would include reports of helpful therapy sessions. The first came many years later, when I finally shared with my family doctor how I often felt. I told him of the feelings listed above, as well as how I was no longer enjoying a number of things that had given me pleasure in the past.

He immediately diagnosed my condition as depression. My first thought? I was glad to know that I wasn’t crazy. That there was an identifiable reason for what was going on with me. A definable disease for which there was treatment. I knew intellectually that I “shouldn’t” have a lot of the feelings I did. This diagnosis provided an explanation.

So at this point in my imagined essay, I would talk about sessions of nearly a year each with three different psychologists spaced over several years. All were helpful, especially the first and third. I was not “cured” by any, though I gained some tools that helped me cope better. In time, I’ll go back for another tune up. Yes, I tried many prescribed anti-depressants, but I’m in the 40 percent for whom such medications are not effective.

I would want to note that someone with depression is not always down. We smile, we laugh, we enjoy. At times.

What would be the reaction?

It seems that more and more well-known people, including entertainers and athletes, are opening up about their own struggles with depression and other mental health issues. They want to help destigmatize mental illness. Some say it’s also therapeutic. As each comes forward, I ask myself if I would do well to do so, too.

Yet, I worry about how people would take it. What would they think of me? Would they treat me any differently? I wonder these things, even though I think more of people who share their struggles. And I don’t treat them any differently.

Or would they make light of it? Maybe the reactions would be similar to the unhelpful words I listed in the third paragraph above. Or similar to a reaction I often get on the rare occasion I dare to mention a physical health concern — i.e., “I have (or someone I know has) the same problem, only worse, and have (has) had it longer.” This response seems to devalue my concern.

Would I end up feeling better or worse?

Another barrier is that I haven’t completely stopped buying into the very stigma I want to counteract. That’s a little ironic, I guess, as is the fact that my depression-nurtured lack of self confidence makes it difficult to take this step.

The S word

If I did take it, I might mention suicidal thoughts. Or I might not. Or maybe just say I wish I didn’t know as much as I do about what it’s like to have them.

I could share significant difficulties I have with light deprivation. Or difficulties getting out of bed sometimes. Times of feeling bad that I feel bad. And how motivation can be a problem when feeling “what’s the use?” or struggling with low self-esteem. I could talk about a well-developed sense of “don’t belong,” which can crop up in almost any context.

That would probably lead to an acknowledgement of ever-present social anxiety. I could admit to worrying before a social event that I’ll say something stupid; worrying during that I am saying something stupid; worrying afterward that I did say something stupid. (Worrying now that this all sounds stupid.)

Then I might note how easy it is to be embarrassed by things others would just laugh off and humiliated by things others might just find a little embarrassing.

I would, if I could muster enough self-confidence, claim some ability as an actor. For the past few of my infrequent appearances in a play, when writing a brief bio for the program, I’ve thought of adding this to the list of past performances: Has portrayed a mentally-healthy person in everyday life 24/7 for many years. If I wrote my own mental health confessional.

A boost in status

We had an investigative newspaper reporter in our area for many years. He garnered the requisite amount of both praise and scorn that accrues to the most successful in his field. I won’t weigh in on those evaluations. I will just acknowledge the positive effect he had on my self image.

I was working in public affairs at the local medical center, owned and operated by our state. My salary was exactly one-tenth that of the CEO of the hospital. My position was roughly analogous to that of a second lieutenant in the military.

Yet this intrepid reporter promoted me to “honcho.”

The budget relied on patient revenue and whatever the legislature would kick in, plus charitable contributions. Administrative costs common to all good businesses include community relations, in-service training and employee relations. There were some programs associated with these objectives that were, at one time, covered by income from vending machines throughout the medical complex, rather than the patient revenue, tax money and contributions.

This did not escape the notice of our reporter friend. When the story broke, he said these funds were spent on “honchos.” I was a participant in three of the activities he listed: Chamber of Commerce membership, “a public affairs dinner” and a recreational softball team. Suddenly, I was elevated in status. I had never been a honcho before, but I stood a little taller and walked with a spring in my step.

As the second-largest employer in our community (the University being first), it is incumbent on the hospital to be a good corporate citizen. Participating in the Chamber of Commerce seems logical. Community-relations responsibilities within our office were assigned to me. So it made sense for the hospital to cough up the $25 a year it cost for me to be one of the individuals designated to represent it in the chamber.

What the article did not say about the dinner was that it followed an educational session, designed to help us do our jobs better, which we were required to attend outside regular work hours.

The softball team participated in the town’s recreational league. The hospital paid the entry fee. Anyone could be on the team, even players as lousy as I. There were a couple of guys pretty high on the flow chart, but most were much lower. At least one player worked in housekeeping.

After the “scandal” came to light, there were changes. Honcho though I was, I wasn’t privy to exactly how the raked-up muck was cleansed. I do know that the hospital started its own softball league, which I guess cost no money other than buying equipment, renting fields and the hours of staff time required to coordinate it. Community-relations activities continued to include chamber participation, paid for somehow. In the public affairs office, we still had the occasional professional-development session. Since they were still after hours, they still fed us, just not using vending-machine money.

In any case, honcho status had been conferred on me, and I wasn’t going to relinquish it.