The Letter I Didn’t Write

[Content note: depression, suicide, self-harm, eating disorders, sexual assault]

This is a long and intensely personal post about college, which I graduated from today. I’m writing it more for myself than for you, so feel free to skip it if you come here mainly for the political rants and psychological babble.

A few weeks ago I got a Facebook invite about a book that some students were compiling. Any current Northwestern senior could contribute a letter, anonymous or not, about their four years at Northwestern, addressed either to themselves four years ago or four years from now. This fall, incoming freshman will receive a copy of the book.

I waffled for a few weeks, finally convinced myself that I had nothing to say, and let the deadline pass.

Of course, that’s not true. I had plenty to say, but I knew that if, four years ago, I had received a letter from my current self about my college experience, I would’ve packed back up and ran the fuck away. Why do that to an innocent freshman?

If you don’t have anything nice to say, don’t say anything at all.

I’ve heard this for my entire life, and it’s the little voice in my head that so often keeps me silent. But usually I can ignore it, which is why this blog exists.

This time it worked. While I won’t say that I have nothing nice to say about my four years at Northwestern, most of it is not very nice. So I stayed silent.

But now it’s my graduation day, and, as with everything else in my life, I can’t fully process or move on from these four years without writing about them. Besides, this is my blog, not anyone’s book meant to provide inspiration and guidance to a new generation of Northwestern students. This space is mine, and this is the letter I didn’t write.

~~~

[Read more…]

Depression and the Lie of the “Real Self”

[Content note: depression and suicide]

Mitchell of Research To Be Done has a fantastic post up about this idea that when you’re on psychiatric medications, you’re not “the real you.” I’ll shamelessly quote about half the post:

This is just a for the record, for everyone, whether you’re talking about antidepressants or any other form of medication or life circumstances: THERE IS NO SUCH THING AS THE “REAL YOU”.

You know why? Because HUMAN BEINGS ARE CONTEXT-DEPENDENT CREATURES.

You are the real you when you’re being flirty and charming and totally hitting it off with someone adorable. You are the real you when you’re crying on the floor of your room and wishing the world would end. You are the real you when you’re living it up on vacation and you are the real you when you’re just getting through the day at a boring job. You’re the real you when you’re on vacation and hate everything about it, and you’re the real you when you’re flying through the day at an amazing job. You are the real you when you’re at a party, and you’re the real you when you’re staying in with your cat. You are the real you when you’re drinking, when you’re high, when you’re reading, when you’re fucking, when you’re lonely, when you’re surrounded by friends, when you feel absolutely worthless, when you’re brimming with confidence, when you wish the universe would leave you alone, and when you love everything about it. You’re the real you when you’re unspeakably angry and hate everyone, and you’re the real you when you’re ecstatically in love and feeling on top of the world.

“THE REAL YOU” IS A MEANINGLESS TERM USED BY PEOPLE WHO DON’T UNDERSTAND HOW HUMAN BEINGS WORK.

I wanted to expand on that idea a bit and talk about why it’s extremely harmful to people who are suffering from mental illness.

When I was depressed, I believed that Depressed Me was The Real Me. Not only that, but I believed that my depressed view of the world was The Most Accurate View Of The World. That when I was depressed and thought that everyone hated me and that I was an alien in this world who should die because I don’t belong here, that was, in my opinion, the most authentic view I could possibly have.

A large part of me feared recovery. Cheerful people grated on me, and of course, in this optimism-fetishizing culture, I thought that the only alternative to miserable depression was peppy, bubbly cheerfulness. That, after all, was what everyone seemed to want me to be, and that felt wrong wrong wrong.

There were a lot of reasons for my belief that depression was “real” and happiness was “fake.” First of all, as I just mentioned, I had a totally skewed image of what happiness actually looked like. Many people make that same mistake, of course, and it’s only now, when I’m healthy and happy but not that outwardly cheerful, that I realize that happiness just doesn’t always look like that. Sometimes it looks like hours spent alone reading. Sometimes it looks like passionate anger at injustice, and doing something about that injustice. Sometimes it looks like writing over 1,000 words in a sudden rush of ideas and creativity. Sometimes it looks like playing footsie with a partner while we do our homework in silence. Sometimes it looks like sitting at the coffee shop with my best friend, just talking about stuff. Sometimes it looks like savoring a meal I cooked myself. Sometimes it looks like waking up early on my first day back in the city, putting money on my metrocard, taking the subway, and walking up the stairs out onto the street, awestruck every time. Sometimes it looks like the moment I received my graduate school acceptance letter. And sometimes it does look like exactly what you’d think–dancing with friends and strangers at a party, knocking back shots and laughing at our own stupidity.

A second reason I believed depression was more “genuine” was that there was definitely a bit of sour grapes going on. No matter what I did, I hadn’t been able to feel happy with myself and my life since early childhood. That’s a lot of failure for a young person. So by late adolescence I was spending a lot of time being like “FUCK YOU HAPPINESS I DIDN’T WANT YOU ANYWAY YOU’RE ALL FAKE AND BORING AND SHIT.” It seems childish, but it was probably one of the only defenses I had. If I’d really known what I was missing, really felt its absence, I’m not sure how I could’ve made it through.

Third, it’s hard to ignore the fact that, even as Western culture promotes optimism and cheerfulness and happiness as mandatory, especially for women, it simultaneously elevates misery and depression to an exalted status. There’s a stereotype of depressed people as writers or artists, people who See Humanity As It Really Is and bring those insights to us through beautiful works of art or literature, and who die alone, unappreciated, perhaps drunk in a gutter or by suicide.

For a pitifully long time, in fact, I wondered if I could ever be a Real Writer if I became happy.

In his book Against Depression, Peter D. Kramer writes:

To oppose depression too directly or completely is to be coarse and reductionistic–to miss the inherent tragedy of the human condition. And here it is not only the minor variants–the psychiatric equivalents of tennis elbow–that bear protecting. Asked about eliminating depression, an audience member may answer with reference to a novel that ends in suicide. Or it may be an artist who is held forth, a self-destructive poet. To be depressed–even quite gravely–is to be in touch with what matters most in life, its finitude and brevity, its absurdity and arbitrariness. To be depressed is to adopt the posture of rebel and social critic. Depression is to our culture what tuberculosis was eighty or a hundred years ago: an illness that signifies refinement. Major depression can be characterized as more than illness, or less–a disease with spiritual overtones, or a necessary phase of a quest whose medical aspects are incidental.

(How can this image of the depressive exist in the same culture that stigmatizes depressives as pathetic, lazy, selfish, whiny losers? Why, you have to be depressed in the right way, of course.)

The final reason, I believe, was a property of the illness itself. The thoughts and emotions conjured by depression are so strong, so urgent, so potent that they felt more real than anything I’d ever felt before. The insights it gave me–they felt so brilliant at the time–could never come to me any other way. There was no other way to just know all these things about Life and Humanity. (This is also why I think that some of the aforementioned artists and writers might not be quite so brilliant as we may think.) When I was depressed I felt like a character in one of the Russian novels I love (where depression, incidentally, often plays a starring role). What could possibly be more genuine than this?

And during those times I’d forget how good it felt not to be depressed. I simply lost access to those memories. I wanted desperately to not be depressed anymore and I was also desperately afraid of who I would become if I were to stop being depressed. Depression skews and poisons everything. All of your memories, all of your identities, every sense you have of who you “really” are.

The result of all of this is that I felt that my depression was authentic. It was The Real Me. Recovering, especially through taking medication, would not be The Real Me.

I can’t know for sure now how that affected my eventual recovery. There are those who say that it must’ve significantly delayed it because I had to Really Want To Get Better and all that, but that’s straight-up victim-blaming bullshit. I DID want to get Better. I was just lost and confused and didn’t know what Better would even look like. And even when I didn’t want to get Better, that was a symptom of the illness itself. Depression is a feedback loop.

I do know that it made the decision to take medication (which brought me back from the brink) a lot more difficult than it needed to be. All that anxiety about potentially losing my ability to write was a waste of time and energy. Those fears that people would only like me if I was Deep and Insightful and Mysterious? They were crap.

And, anyway, here I am, nearly a year post-recovery and still writing, still being moody and weird, still doing my best not to have an overly rosy view of the world. Still ruining your fun.

But it’s deeply unjust to trick people suffering from depression into believing that they won’t be their Real Selves if they recover (especially if they recover using medication). People love to be all like “Yeah well what if anti-depressants had been around in Van Gogh’s time?” Well, maybe we’d still have his amazing art. Maybe it would look a little different. Or maybe Van Gogh would’ve done something totally different with his life and we’d never know the difference.

All I know is, no painting in the world can be so beautiful as to justify that sort of suffering.

Criticizing Psychiatry Without Throwing the Baby Out with the Bathwater

So, I read this article in The Atlantic called “The Real Problems with Psychiatry” and…I’m torn. The article is an interview with this guy Gary Greenberg, a therapist who has previously written a book called Manufacturing Depression: The Secret History of a Modern Disease and has now followed that up with The Book of Woe: The Making of the DSM-5 and the Unmaking of Psychiatry.

Now, to be clear, I haven’t read either of these books. I might, just to see the full depth of his arguments. But I decided to read the interview anyway and assume that he accurately represented his own claims in it.

Parts of the interview, I think, are really on point. Greenberg discusses the history of the DSM (the manual used to diagnose mental disorders) as a way for psychiatry as a discipline to establish credibility alongside other types of medicine. He criticizes the DSM on the grounds that the mental diagnoses that we currently have may not necessary be the best way to conceptualize mental illness, and he thinks that once we gain a better understanding of the brain we will find that they have little to do with the physical reality of mental illness:

Research on the brain is still in its infancy. Do you think we will ever know enough about the brain to prove that certain psychiatric diagnoses have a direct biological cause?

I’d be willing to bet everything that whenever it happens, whatever we find out about the brain and mental suffering is not going to map, at all, onto the DSM categories. Let’s say we can elucidate the entire structure of a given kind of mental suffering. We’re not going to be able to say, “here’s Major Depressive Disorder, and here’s what it looks like in the brain.” If there’s any success, it will involve a whole remapping of the terrain of mental disorders. And psychiatry may very likely take very small findings and trump them up into something they aren’t. But the most honest outcome would be to go back to the old days and just look at symptoms. They might get good at elucidating the circuitry of fear or anxiety or these kinds of things.

I don’t know if he’s right. But I suspect that he might be.

He also makes a great point about the fact that we often assume that anyone who acts against social norms, for instance by committing a terrible crime, must necessarily be mentally ill:

It’s our characteristic way of chalking up what we think is “evil” to what we think of as mental disease. Our gut reaction is always “that was really sick. Those guys in Boston — they were really sick.” But how do we know? Unless you decide in advance that anybody who does anything heinous is sick. This society is very wary of using the term “evil.” But I firmly believe there is such a thing as evil. It’s circular — thinking that anybody who commits suicide is depressed; anybody who goes into a school with a loaded gun and shoots people must have a mental illness.

Greenberg also discusses how mental diagnoses have historically been used to perpetuate injustice, such as the infamous “disorder” of “drapetomania,” which was thought to cause slaves to try to escape their masters, and the fact that homosexuality was once considered a mental illness (and other types of sexual/gender variance still are).

He also talks a lot about how the DSM and its categories are tied in with all sorts of things: scientific research and mental healthcare coverage, for instance:

To get an indication from the FDA, a drug company has to tie its drug to a DSM disorder. You can’t just develop a drug for anxiety. You have to develop the drug for Generalized Anxiety Disorder or Major Depressive Disorder. You can’t just ask for special services for a student who is awkward. You have to get special services for a student with autism. In court, mental illnesses come from the DSM. If you want insurance to pay for your therapy, you have to be diagnosed with a mental illness.

The point about needing a DSM diagnosis in order to receive insurance coverage is really important and cannot be overstated (in fact, I wish he’d given it more than a sentence, but again, he did write books). As someone who plans to eventually practice therapy without necessarily having to formerly diagnose all of my clients, this matters to me a lot, because it may mean that I might have to choose between diagnosing and working only with clients who can afford therapy without insurance coverage (which, at at least $100 per weekly session, would really not be many).

But sometimes Greenberg makes a good point while also making a terrible point:

One of the overlooked ways is that diagnoses can change people’s lives for the better. Asperger’s Syndrome is probably the most successful psychiatric disorder ever in this respect. It created a community. It gave people whose primary symptom was isolation a way to belong and provided resources to those who were diagnosed. It can also have bad effects. A depression diagnosis gives people an identity formed around having a disease that we know doesn’t exist, and how that can divert resources from where they might be needed.

First of all, we don’t “know” that depression “doesn’t exist.” We know–or, more accurately, some of us suspect–that the diagnosis we call “major depression” might not map on very accurately to what’s actually going on in the brains of people who are diagnosed with it. What we call “major depression” is a large cluster of possible symptoms, and since you only have to have some of them in order to be diagnosed, two people with the exact same diagnosis could have almost completely different symptomology. Further, because depression can vary like a spectrum in its severity, the cut-off point for what’s clinical depression and what’s not can be rather arbitrary. It’s not like with other types of illnesses, where either you have a tumor or you don’t, either you have a pathogen in your bloodstream or you don’t.

Second, Greenberg doesn’t seem to extend his analysis of the effects of the Asperger’s diagnosis onto other disorders. There is absolutely a community of people who have (had) depression, eating disorders, anxiety, and so on. Those communities are absolutely valuable. My life would be demonstrably worse without these communities. They haven’t “diverted resources” from anything other than me wallowing in self-pity because I feel like I’m the only person going through these things–which is how I used to feel.

Right after that:

What are the dangers of over-diagnosing a population? Are false positives worse than false negatives?

I believe that false positives, people who are diagnosed because there’s a diagnosis for them and they show up in a doctor’s office, is a much bigger problem. It changes people’s identities, it encourages the use of drugs whose side effects and long-term effects are unknown, and main effects are poorly understood.

Greenberg is correct that false positives are a problem and that diagnosing someone with a mental illness that they do not have can be very harmful. However, his dismissiveness of the problem of false negatives–people who do have mental illnesses but never get diagnosis or treatment–is stunning coming from someone who is a practicing therapist. Untreated mental illnesses are nothing to mess around with. They can lead to death, by suicide or (in the case of eating disorders) otherwise. Even if things never get to that point, they can ruin friendships, relationships, marriages, careers, lives. While I get that Greenberg has an agenda to push here, some acknowledgment of that fact would’ve been very much warranted.

In short, Greenberg seems to make the logical leap that many critics of psychiatry and the DSM do; that is, because there is much to criticize about them and because it’s unclear how valid the DSM diagnoses are, therefore depression is “a disease that we know doesn’t exist” and antidepressants are harmful (that’s a whole other topic, though).

Antidepressants may very well be harmful. Diagnostic labels may also very well be harmful, for some people. But I think the stronger evidence is that untreated mental suffering is harmful, and sometimes therapy just isn’t enough and cannot work quickly enough–for instance, for someone who is severely depressed to the point that they can’t possibly use any of the insights they may gain in therapy, or to the point that they are about to commit suicide.

I hope that one day we’ll have all the answers we need to minimize both false negatives and false positives. But for now, we don’t, and I worry that attitudes like Greenberg’s may prevent people from getting the help they urgently need, as much as they may simultaneously promote vital criticism and analysis of psychiatry and the DSM.

~~~

Note: I didn’t fact-check everything Greenberg said in the interview because I’m hoping that The Atlantic employs fact-checkers. But if you have counter-evidence for anything in that article, even parts I didn’t quote here, please let me know.

Living With Depression: Strength

[Content note: depression]

Half a year ago I started a series of posts about living with depression in order to help people understand what it’s like to have it beyond just the DSM symptoms that you always hear about. Then I moved to FtB and got super intimidated and didn’t want to write it anymore. But now I have writer’s block and I’m feeling too overwhelmed by everything going on in the world so I’m going to write about myself.

It’s not meant to reflect anyone’s experience but my own, although I’m sure plenty of people will identify with it. If things were completely different for you and you feel comfortable sharing, the comments section’s all yours.

The two previous posts, if you’re curious, were about trust and openness.

For many people, both sufferers and non-, depression is primarily a lack of strength.

Emotional strength, that is. When you hear people call depression a “weakness,” consider the fact that the opposite of “weakness” is “strength,” and you’ll see exactly what they think is lacking in those who suffer from it. Of course, enlightened as depression sufferers supposedly are about their own illness, most of us fall into the same trap at some point.

Because on the surface, depression really can look like a lack of strength. For many years, at the slightest sign of misfortune or difficulty–a bad grade, a rude remark from someone–my entire mental composure would crumple like a dry leaf you crush in your hand. Imagine going to the gym and trying to lift one of the lightest weights they have, but you drop it and collapse in a heap on the floor. That’s approximately the physical equivalent of how it feels, with all the humiliation and self-blame involved.

In reality, of course, it has nothing to do with weakness or strength. It’s an illness. It’s not your fault. (It’s not a “chemical imbalance,” by the way, as someone would usually say right about now, but it’s not a weakness either.)

But, honestly, most days I can’t internalize that knowledge, no matter how many courses I take and articles I read. I feel weak.

Anyway, my solution to this for a while was to try to present a false persona that is strong, competent, and detached. I spent a lot of time furiously pretending not to care about things, because that’s what I thought strength was. It never worked. I’m sure people saw through it, and besides, the thing with depression is that often you can’t fake your way out of it. The pain and emotions it causes are too powerful to hide. It’s like the difference between not letting it show on your face when you’ve stubbed your toe, and not letting it show on your face when you’ve fractured your leg in three places. People are gonna be able to tell. No matter what.

And that inability to hide what I felt was private, shameful, and weak was probably the worst way I’d ever felt like I failed myself. Worse than not liking college, worse than having to drop journalism, worse than not getting (or having to decline) a slew of coveted internships and other opportunities. In the endless parade of personal failures to which I am a constant, unwilling spectator, failing to be “mentally strong” is the absolute worst.

So what about physical strength, then?

It’ll probably come as no surprise (as I’m sure I’m far from the only person who does this) that I use physical strength and competence as a way to distract from and make up for the emotional strength that, despite everything I know about depression, I still feel I do not have.

I’ve been doing that for as long as I can remember. I used ballet that way when I used to dance, from when I was 6 years old until I was 15. Then I switched to marching band, which you may think isn’t hard until you’ve done it. During the off-season I’d bike or walk pretty long distances or go to the gym or exercise at home. Of course, all that was irrevocably tainted by the fact that I had massive body image issues and eating habits that at times were very unhealthy, but I do remember the difference between wanting to lose weight and wanting to be strong. I haven’t always wanted to lose weight, but I’ve always, always wanted to be strong.

(Of course, physical strength is a gendered trait, and the gender that we usually associate it with is male. That means that we think of physical strength as being able to lift a whole lot of pounds–with your arms, that is–and it means that my male friends scoff at how pathetically I compare to them in that department. Of course, I just smile and roll my eyes, because I’d love to see them sit calmly in the splits for 15 minutes while reading a book, or twirl on the toes of one foot. Whatever.)

Partially, I like being strong for the same reasons anyone else does–it feels good, it’s useful, it keeps you healthier. But also, it allows me to shape my body in the way I’ve never managed to shape my mind. Getting physically strong requires a lot of effort, sure, but everyone knows exactly how it’s done. I don’t know how to stop being so emotionally nonresilient. I only know that sometimes I go months without any problems, and then suddenly, for no reason, I start crumpling again.

Muscles don’t work that way. You work them out, and they get stronger. You don’t work them out, and they eventually get weaker. You know which exercises work out which muscles. You know that if muscles are sore, you gave them a good workout. (I say this as I can barely walk for the third day in a row because of this thing I did with my calves, so there ya go).

If I were able to afford a therapist who could actually help (as opposed to the ones that I’ve had, who did not), maybe I’d eventually become emotionally strong. But for now I’ve mostly given up. The only thing that works when I feel weak is simple distraction, but the more tired and overwhelmed I am and the more mental effort I’ve already exerted on other things, the harder distraction gets.

But when I feel strong physically, it makes up for not feeling strong emotionally. Just a little bit.

Lessons I Learned From Depression

[Content note: depression]

People struggling with mental illness (or any sort of illness, or anything crappy, really) are constantly exhorted by well-meaning people to find the “silver lining” in their experience. This often takes the form of tropes about “learning who your real friends are” or “learning how to fully appreciate life” or “understanding what’s really important in life” and on and on.

For a long time I resisted the entire notion of finding “lessons” or “learning opportunities” in my decade-long struggle with depression. (Yes, decade-long. Yes, I’m 22.) Part of this was because the people who demanded that I do so were just so damn annoying, frankly. No, I will not spin you a convenient story about What Depression Has Taught Me to make you feel better when you see my tears or my scars.

But mostly I resisted because I felt that admitting that I’ve learned things from this experience requires intentionally forgetting the fact that most of it had no meaning. There is no meaning to losing half of your life to something you can’t even see or prove to people or sometimes even describe in words. There is no meaning to having most of the memories of your life discolored, blurred, and tainted by a misery and terror that had no name. This is not the stuff of inspirational memoirs or films. While some people suffer for political causes or for their children or in order to produce a great work of art, I suffered for absolutely no reason at all.

But, of course, I did learn some things. Maybe I would’ve learned them even if I’d had a more normative emotional experience, but right now it really seems like I learned them as a result of being so miserable a lot of the time. And while I reserve a very special fury for those who implore us to create meaning out of meaningless suffering and produce “lessons” and “silver linings” and “bright sides” carefully repackaged for their consumption, I think these are lessons that are worthwhile to share.

I am not my GPA, weight, debt, scars.Lesson 1: Not everything your brain tells you is accurate.

Most people, I think, go through life without giving much thought to whether or not their perceptions are providing them with the most accurate possible picture of reality. But sometimes our brains are pretty crappy at this. Of course, I would’ve learned that without the help of depression, because I study psychology. So I’ve known for a while about stuff like the fundamental attribution error, the halo effect, anchoring, confirmation bias, the Dunning-Kruger effect, the false-consensus effect, the just-world hypothesis, in-group favoritism, the hot-hand fallacy, the Lake Wobegon effect, status quo bias, and all sorts of other biases, fallacies, and errors.

But what really brought it home was depression. While the cognitive errors I’ve listed are generally adaptive and keep people happier, depression was the opposite. Instead of telling me that people like me despite evidence to the contrary, my cognitive distortions told me that everyone hates me despite evidence to the contrary. Rather than telling me that I’m above-average in most things, they told me that I’m below-average in most things. On any given day I would invariably feel like the stupidest, ugliest, least likable, most worthless person alive. True story.

At some point it occurred to me that I would never recover if I didn’t learn how to treat what my brain said with a healthy amount of skepticism. So I started to. (Perhaps not coincidentally, this was the time in my life when my political views evolved the most, because I also started challenging my knee-jerk reactions to various issues in our society.) Of course, this is a lesson that is not limited to folks with mental illnesses, because everyone’s brain does this to them at some point. For many people, including some of those who proudly label themselves “skeptics,” thinking critically about what happens inside one’s brain does not come nearly as easily as thinking critically about what happens out there in the world.

So, for me, this meant a lot of time spent repeating to myself, “Yes, I feel like Best Friend hates my guts, but that’s just a feeling and it’s not necessarily true” and “Yes, not getting that internship makes me feel like I’m a complete failure who will never amount to anything in her chosen field, but that’s just my brain lying to me again” and “Yes, Partner wants to see their friends rather than me tonight, but this doesn’t mean that Partner doesn’t care about me and doesn’t want to keep seeing me anymore.”

Pause, rewind, repeat, and there you have my recovery.

Lesson 2: Your feelings are valid.

Does this seem like a contradiction to the previous lesson? It’s not. Unfortunately, when confronted with the apparently irrational emotions of others, many people immediately jump to the conclusion that those emotions are WRONG. (These people should never try to be therapists.)

However, just because someone’s emotions do not seem like a “rational” response to what they’re going through, that doesn’t mean there’s no reason for them. That reason can be whichever complicated and still-misunderstood brain processes cause depression. It can be that those are the emotions they saw expressed in their families growing up, and learned to mimic at an early age. It can be that last time this sort of thing happened, it ended terribly and now they’re freaking out over this seemingly minor thing because it could end that badly again. It can be that what’s currently happening to them is reminding them of something else entirely.

Or it could be for any number of other reasons that you do not know, and that the person having the “irrational” feelings might not know either. So why assume?

It’s important to remember, too, that there tends to be a pattern to the emotions we decide are “irrational” and “inappropriate” in others. Anger from a woman or a person of color is perceived differently than anger from a white man. Sadness from a woman is perceived differently than sadness from a man. Archetypes like the Angry Black Man and the Hysterical Woman are sometimes so deeply ingrained that we don’t even notice ourselves applying them.

But all emotions are valid. Some are less adaptive than others, some we want to change, some can contribute to unacceptable behavior if we don’t address them, yes. But they’re all valid, and telling others (or ourselves) that some emotions are not okay to have doesn’t help in changing them.

Lesson 3: Sometimes you have to keep your mental health in mind when making decisions.

This is the one I’ve resisted the most. I had to quit studying journalism because it was giving me panic attacks, and I chose not to pursue a PhD in part because I didn’t think I could handle it emotionally (well, and because the thought of it just bored me). When it comes to my personal life, my mental health is a big part of the reason I gave up monogamy, although I’m now glad I did for many other reasons. It’s also part of the reason I never studied abroad, gave up many other opportunities, and chose to move to NYC.

When I first started to realize that mental health is a factor that I need to consider when making decisions about my academic, professional, and personal life, I felt abandoned and betrayed by my own brain. I understood intuitively that sometimes you can’t do things because they require physical traits or abilities that you lack or because you don’t have the cognitive skills or because you just lack access to those opportunities. But to have all those things and still give something up just because my brain doesn’t like it? That seemed ridiculous.

In fact, that way of thinking is just an extension of the stigma of mental illness. Just as we think that mental illness isn’t really “real,” we think that mental health isn’t really important. It’s reasonable, we think, to choose not to live in Florida because you can’t deal with the weather or to choose not to go running because it’s too hard on your knees or to choose not to be a physicist because you can’t do math worth a shit, but not getting a PhD because grad school would make your depression relapse? Not being a journalist because interviewing people gives you panic attacks? Not studying abroad because being away from people you love makes you suicidal? What the hell is up with that. Just deal with it.

So for a long time I did stuff that made me miserable because I was fighting so hard against the notion that mental health is something you need to take care of and cultivate, just as you would with your physical health. But one of the most important things I’ve learned how to do in college is knowing when to say “no” to things that sound fantastic but might break down the levees I’ve built up to keep the depression from flooding in.

Of course, sometimes it still makes me furious. I recently gave up a great opportunity for that reason; I badly wanted to do it but every time I thought about actually doing it, and the sacrifices it would entail, I broke down, sobbing, paralyzed, unable to say yes or no to it. Eventually I finally turned it down, full of resentment at myself and my useless brain, but trying to understand that my reason was a good one and that I deserve permission to make this choice.

Now, naturally, there are those who would tell me to Just Do It! and Get Out Of Your Comfort Zone! and blabbityblahblah, but those people will just have to trust me when I say that I know the potential dangers much better than they do. Mental illness is a whole ‘nother ballgame. When I want to Get Out Of My Comfort Zone! I try getting to know someone new or reading something I disagree with that makes me a bit uncomfortable. When I move to NYC, I can Get Out Of My Comfort Zone! by joining new groups or going to events where I don’t know people and seeing what happens.

That’s getting out of my comfort zone. Ignoring the fact that I have important needs when it comes to my mental health, though, is not “brave” or “spontaneous” or “gutsy.” It’s just irresponsible, just as it would be irresponsible go ride a motorcycle without a helmet or to not wash my hands during flu season.

So give yourself permission to treat your mental health with the care and concern it deserves. Of course, you might be aware that doing something could make your mental health worse and choose to do it anyway for any number of reasons, and that’s completely fine, too.

But so many of us struggle merely to accept the idea that it’s okay not to do things for the sole reason that they might worsen our mental health, and that’s something we have to overcome.

It's okay not to be okay.

LGBT Celebrities Do Not Owe Coming Out To Anyone

Everyone’s got an opinion on Jodie Foster’s speech at the Golden Globes last night. If you haven’t seen it, here’s a video with a transcript.

In the speech, Foster spoke affectionately of her ex-partner, with whom she raised children, and explained that she “already did [her] coming out about a thousand years ago back in the Stone Age” but values her privacy too much to make it a big spectacle.

That’s not a good enough excuse for one writer, though (watch out, it’s apparently Low-Hanging Fruit Day over here at Brute Reason):

I mean, is it 1996? Jodie’s defensive speech, in which she seemed to blame Honey Boo Boo and reality TV for supposedly creating a climate that forced her out of the closet, harkened back to a time when it was a big deal to proclaim your sexual orientation. Hello, it’s 2013! People are getting “gay married” and homos can be out in the military and stuff!

[…]Why am I so angry? Because I’m roughly the same age as Jodie, and yet I had the courage to come out exactly 20 years ago.

I honestly don’t see what is “defensive” about Foster’s speech and where exactly she “blames” current pop culture for “forcing” her out of the closet. She does joke about how celebrities are expected to live very publicly and have their own reality shows and fragrances and whatnot, but the part where she blames this for making her come out seems to be entirely in Baer’s imagination.

Baer goes on and calls Foster’s need for privacy “an excuse” and then offers this bizarre caveat:

A lot of people will criticize this piece and write angry, hateful comments saying that it was up to her when and where to come out, and they’re absolutely right, but that still doesn’t mean she wasn’t a coward, and it doesn’t change the fact that she could have helped millions of people by coming out years ago.

A bunch of things jump out at me:

1. This article seems to be more about the author than about Jodie Foster.

As in, it’s all about Baer and how courageous she was for having come out a long time ago. Even though she doesn’t dedicate that much of the article to talking about her own courage, that’s clearly the main theme–she was courageous and Foster was not.

Baer undoubtedly deserves respect for coming out so early (well, for coming out at all), but that doesn’t mean Foster is a “coward” for not being so public about her sexual orientation. As she explains in her speech, everyone that she wanted to know, knew. That may not be “out enough” for Baer, but it’s still out.

Whenever someone’s done something awesome–come out, for example, or recovered from a mental illness–there’s a certain tension in figuring out how to talk about the people who haven’t succeeded in doing that thing yet without being a total asshole about it. My reasoning is that you don’t know why they haven’t and it’s best not to assume. I suppose Foster could really be a coward, but personally I doubt it. It’s more likely that she had other reasons for not coming out publicly (assuming that the ways in which she has already come out don’t matter, which is what Baer seems to be assuming).

2. Considering Foster’s history, Baer is incredibly dismissive of her stated need for privacy.

Many celebrities guard their privacy carefully, and not all of them have any desire to be in tabloids all the time. But Foster has a unique story in that regard. In the 1980s, a fan of hers named John Hinckley, Jr. became obsessive and started sending her love letters. He then attempted to assassinate then-President Reagan, stating that he was trying to impress Foster. The resulting intrusion of her privacy by the media is something that she’s known to have had a lot of discomfort with.

Given this, one would think that Foster could get away with needing privacy a bit more than the average celebrity, but in rushing to condemn her, Baer misses these nuances.

As Foster said in the speech:

But seriously, if you had been a public figure from the time that you were a toddler, if you’d had to fight for a life that felt real and honest and normal against all odds, then maybe you too might value privacy above all else. Privacy.

3. It’s not Foster’s job to “help millions of people” by coming out.

It’s not anyone’s job, actually. Foster’s job is to make movies. Baer’s job is to write articles about the entertainment industry. All of us should probably try to be decent people and to help others when they need it, but not at the cost of our own well-being. Chastising someone for failing to “help millions of people” just seems odd to me because it presumes that Foster is somehow failing live up to her responsibilities as a person.

It’s undoubtedly true that many people would’ve been happy had Foster come out (or, again, come out more publicly in the way that Baer apparently wanted her to). Perhaps she would’ve been an inspiration for a lot of LGBT kids. But that doesn’t make coming out an imperative. I would probably inspire lots of people if I won a marathon or donated all of my worldly possessions to charity, but that doesn’t make it a moral imperative for me to do so.

4. Baer’s reaction shows an incredible amount of entitlement.

We consider ourselves entitled to a lot from celebrities. They must be Good Role Models. They must always be grateful for their fame, even if they never asked for it and even if it often causes them enormous personal difficulties. (Consider the never-ending excoriation of Kristen Stewart for failing to appear cheerful and grateful enough.) If they’re queer, they must always come out and be willing to serve as advocates for LGBT causes.

You could argue that it’s not healthy or “right” for any queer person to live in the closet (though in my opinion you’d still be wrong). But that’s not what Foster was doing. Given that she had already come out to everyone who matters to her and has lived her life as a gay woman–for instance, by dating another woman and raising children with her–Baer’s presumption that Foster owes us anything more than that is predicated on the fact that she’s a celebrity.

Like many others, Baer assumes that celebrities’ lives exist for her consumption and that celebrities who happen to be queer exist solely to validate her and other LGBT folks. But Foster is a human being. She is a human being who happens to be a famous actress and who also happens to be gay.

5. Baer is shockingly dismissive of the negative consequences that coming out can have for celebrities.

She writes:

Nobody was asking Jodie to be president of the gays. Ellen [Degeneres] is a great example of someone who came out, had no interest in being the poster child and is just living her life honestly and openly. Though she occasionally fights publicly for LGBT causes, being a lesbian doesn’t define her. But here’s the amazing thing that happened to Ellen. At first her big announcement seemed to derail her career. She disappeared for a while and almost gave up on show business because she was “mired in depression.” After some dark days, which a lot of newly out people experience, Ellen ultimately was rewarded for being her true self. Today, because of her talk show, she’s arguably one of the most beloved stars on the planet, adored by millions, gay and straight alike (except for a handful of moms who now refuse to shop at JCPenney, but c’mon, they’re dumb).

First of all, I’m not sure why Baer thinks that Ellen isn’t a “poster child” when such a great deal of media coverage about her has to do with the fact that she’s a lesbian. But second, notice how Baer just skims right over the part where Ellen suffered from depression and nearly quit her career as a result of coming out. As though that doesn’t even matter because she gets to be “her true self” now. As though the bullying from One Million Moms is just a crappy little side effect.

What if that sort of public opprobrium and the depression that can result from it wasn’t something Foster felt capable of dealing with?

Nobody should have to suffer through bullying, depression, and possible career loss for coming out as gay or trans*. I think we can all agree on that here, and many of us advocate in various ways to make coming out easier and safer. But blaming an individual for not being willing to put themselves through this is unconscionable.

I don’t know what private struggles Foster has gone through with regard to her sexuality, and neither does Baer. It’s none of our business. That’s why calling her a coward for not doing what others have done is wrong.

Six Months

Every New Year’s Eve, I write a post about the year that’s about to end. When I was younger, I mostly used these posts to talk about significant things that had happened to me (getting a boyfriend, losing a boyfriend, getting into this or that program or college, and so on), explain what I’d learned from them, and make resolutions for the future.

Looking back over my resolutions from past years is kind of sad for me now. It’s both unsurprising and depressing how many of them concerned random metrics that I’d allowed the world to value me by–GPA, weight, stuff like that.

These were always the resolutions that I was never able to keep.

I don’t do New Year’s resolutions anymore, mostly because my resolution would be the exact same every year: do better, be better.

Over the last few years, the theme of depression has completely taken over these New Year’s Eve posts. In 2010 I wrote about being diagnosed and recovering. That was the first time I wrote about depression publicly, and I’ve continued doing so ever since.

In 2011 I wrote about relapsing and trying to find a way to carry on. At the end of that post, I wrote this:

A few days ago. I’m walking near Union Square in Manhattan. The sun has nearly set and the wind is chilling. I hear a man begging for money.

“Can you spare some change?” he’s saying, over and over. The passerby walk past him and he says, “That’s okay. Maybe next year.”

I put a dollar bill in his cup and he says, “God bless you, miss. I really mean that.”

He says happy New Year, and I say happy New Year too.

And then I continue on my way.

Maybe next year.

Today I returned to that exact spot. Not on purpose or anything. I’m in New York for the week and that spot just happens to be located next to my favorite bookstore in the world, the Strand.

And even though it was cold and I’m not in a particularly good mood today, I realized: the “next year” that I’d been dreaming about has come to pass. That year was 2012.

The end of December marks six months since my depression symptoms suddenly abated last summer. Psychologists seem to agree that at the six-month mark, remission officially becomes recovery. I don’t know what this means other than that I get to say that I’ve recovered.

I feel like I should have some Good Insights about how to recover from depression, but I really don’t. Medication helped me deal with the worst of it, but it stopped working after a while. I never managed to find a therapist that helped, but I’ll keep looking.

There were a number of amazing things that happened to me this year, some of which I attribute to my recovery. However, the interesting thing is that they all happened after my symptoms stopped, not before. Stuff like getting involved in the atheist movement, meeting my best friends and my partner, growing my blog and moving to FtB, finally deciding what I’m doing next year (getting a masters in social work), and so on. My life has changed so drastically over the past six months that I sometimes wonder if recovering from depression somehow opened me up to let all of this in. But I don’t know.

People who suffer from depression are constantly being exhorted to Look On The Bright Side and Be Open To Love and all that stuff, but here’s the thing–I was unable to do any of these things until my symptoms had eased up. I would never have been able to be outgoing enough to meet all the awesome people that I’ve met, and although I’ve been a good writer for a while, it got much easier to handle criticism and promote my blog once I didn’t feel depressed anymore. And while I hope my partner would stick with me if I had another depressive episode, the person I was half a year ago probably wasn’t someone he would’ve been interested in. Sad, but true.

I’d bet that the connections I made after I recovered are a large part of the reason I’m still doing so well, though. Without them, maybe I would’ve relapsed quickly. My writing, my friends, my partner, and even all the random acquaintances I’ve made while blogging are like a large safety net, giving me something other than myself and my moods to focus on when I’m not doing very well. My future, which is starting to clear up and coalesce into an actual set of plans, is always on my mind, reminding me that the college life I’ve never liked is finally ending soon.

I wish I could tell you how I got to that place I was at six months ago, ready to connect with the world in a genuine way for the first time in years. Maybe the illness had just had enough. Maybe I started getting enough vitamins or something and some random chemicals in my brain balanced out. I don’t know.

More likely, though, all the stuff I was reading and writing was finally going to my brain. While feminism certainly can’t cure serious depression, it really got to the roots of a lot of the issues I was having that were contributing to my depression. For the first time, I started to understanding that, yes, I can be serious. I can be critical. I can be passionate. Being these things doesn’t keep me from being a kind, loving person that others can actually appreciate, and it doesn’t have to make me an outcast. In certain social circles, of course, it does. But fuck those social circles. Seriously.

Feminism also showed me what I can expect out of my friendships and relationships. I don’t have to put up with the mean-spirited jokes, I don’t have to accept the shrugs and cold shoulders and eye rolls. I don’t have to deal with people who cancel plans at the last minute and treat me like their own personal therapist without ever offering any support in return. I don’t have to pretend to laugh at sexist, racist, and homophobic comments made “ironically.”

And so I stopped. For a while, this meant I had less friends and had to be more picky. This is fine. As it turned out, I left just enough space in my life for a loving, loud, affirming bunch of feminists to walk right in and become my dearest friends.

There are times when you need to compromise. I don’t expect to have the perfect job in the perfect city any time soon, if ever. I will probably always have a bit too little money. If I find a good enough apartment in a good enough neighborhood for a good enough price, I’ll take it. The thrift store clothes will do just fine.

But when it comes to friends and lovers, I will not settle. Ever. Again. When it comes to my writing, I will say what I want.

My happiness now does not come from the academic achievement I used to yearn for. I never did lose that weight. Those resolutions were all bullshit. When I see people getting these things, I sometimes reflexively feel jealous and then I remember:

I have beaten an illness that consumed my mind for nearly a decade, and I beat it without any of that stuff. For six months now I have been happy, sometimes so happy I could cry, without any of it.

The clock will tick on, six months will turn into seven and then eight and then more, and maybe someday I will lose count of how long it has been since I found myself again.

Happy New Year.

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New Year in New York.

How It Feels To Shed Your Skin

Being a young and mobile person is a bit like having a never-ending case of whiplash.

I don’t have a single identity or home or social circle; I have many, and I’m constantly leaving one for another and feeling like the skin that has been grafted onto my preexisting skin is being ripped off and the resulting wound is replaced with another.

There is my life at school, which is the busiest and most visibly meaningful (but actually probably the emptiest) life of them all. There is who I am with my family in Ohio, and who I am when I visit my intended future home, New York City. I am someone else entirely apart from all these people with my long-distance partner (first one, then another) when one of us is visiting the other.

Leaving each of these is like heartbreak. At that moment it feels like nothing is deeper and truer than who I am in this place, with these people, at this point in time. I tell myself over and over that once I get to my destination I will become that person and it’ll feel normal again, but no amount of telling it makes it feel true. It is always like leaving myself and becoming someone else, someone I don’t want to be. And upon arriving I briefly experience the sickening feeling of having become someone I dreaded becoming just a few short hours before, across a few state lines or perhaps a two-hour flight away. That feeling squeezes me by the throat and then finally slinks away and I grow comfortable and complacent in my new (old?) skin.

Shortly before leaving I often grow aloof and distant from the people I’m with, and this breaks my heart even more. And probably theirs. It pains me, but it seems better than letting myself stay close for those final hours, which would mean letting them see me collapse in tears as I imagine being torn away from them by whichever car, bus, train, or plane is doing it this time.

There is a certain courage that you need to let someone wipe your tears away, and it is a courage I rarely have these days.

The reason I need courage is because there is so much to be afraid of. People misread the particular mix of emotions I feel when I’m leaving and assume that I must be pathologically attached to them or confused about where I “belong” (why the hell do I hate Ohio so much but invariably lose control of myself when leaving it?). The truth is, yes, I get very attached to people. But I don’t think there’s anything pathological about the way in which I get attached. I think the difference between me and people who aren’t depressed is that, sometimes, the way you keep from being depressed is by choosing not to acknowledge the enormous amounts of pain and pleasure that others can give to you, and living as though you are truly independent.

Whose way is better? I can’t say, but I know that I’m incapable of ignoring the bonds between myself and the people I love for the few hours it takes for me to leave. And because I can’t ignore them, having to sever them over and over and then splice them back up and sever them again, every couple of months, feels like the worst thing in the world.

Someone pointed out to me recently that the same theme keeps coming up whenever I tell the story of my life, how I came to be so depressed, and how I eventually (mostly) recovered. That theme is disconnection. My worst misery is when I feel disconnected from people, society, and life itself. It’s when I feel misunderstood by the people close to me or when I feel like an outsider (this happens often to me; if you read my previous post you can see a little snippet of it). Or when I feel like I just don’t understand the people around me and why we can’t seem to agree on anything, or when I feel like I have no traditions to give shape to my life, or when I feel like I’m not “fully” any of the things that I think I am–feminist, atheist, Jew, Russian, Israeli, woman, student, activist.

(In my better moments, I realize that, well, of course I’m not “fully” any of these things. Nobody can possibly fit some hypothetical Aristotelian prototype of any of these things. The very nature of such identities is that the pressure to belong and conform is significant and that we will always wonder if we’re really measuring up to what we’re “supposed” to be.)

On the other hand, the greatest happiness I’ve ever known is feeling connected to people and ideas and places. It’s the feeling I had at Skepticon. It’s reading a brilliant book or article and feeling completely in sync with the author. It’s holding someone I love close. It’s discovering that my partner and I both hate Michael Cera and love Los Campesinos! and agree on virtually every ethical and political issue that we care about.

Given this, it’s not very surprising that I have such difficulty with transitions. Of course, everything is ultimately temporary and change is part of life for everyone, but this much temporariness and this much change is just too much. That whiplashy feeling I get every time I have to switch identities and hop across state lines is a sign that someone like me just isn’t made for this lifestyle.

I have strategies to help me cope with it, of course. I always carry things from one place to another to help me remember who I am when I’m somewhere else. I have stacks of notebooks from other times. I almost never recall old memories.

Mostly, though, I write. Telling you this right now is the only thing that’s helping.

A while ago, I wrote that the happiest day of my life up until that point had been my older brother’s wedding, because I got to spend a whole day focusing entirely on other people and not on myself. My new sister-in-law read it and replied that she felt much like I did when I was younger and that once you grow a bit older and start to settle down, it gets easier. Not necessarily because Change Is Bad, but because people like me are at a stage in our lives where we are basically required to focus on nothing but ourselves. Our education, our needs, our desires, our constant criss-crossing of the country in search of opportunities. Once you’re able to turn that focus outwards at other people, that feeling of disconnect subsides and real, lasting happiness–not the kind you might get from parties or straight As–can take its place.

I hope she’s right. I hope that after I’ve finished all of my degrees and chosen a city to live in, life will stop jerking me around like this every few months. I hope that I can finally build a network of friends and acquaintances that will be more or less stable. I hope that the people I spend time with will have known me for longer than a few months. I hope that my work will feel more meaningful than my schooling.

I hope, because tomorrow I will rip myself out of one skin and shoddily sew myself into another, and the person I am right now, as I write this, will already be just a distant memory.

“Home”

This week I learned that depression and writer’s block together is a scary thing, as writing is my primary way of alleviating depression. Then I realized that the reason I couldn’t write was because I was refusing to write the piece that was trying to come out. When I finally let myself “feel the feels,” this is what resulted.

In the dark and the stillness, the floor of my family’s house creaks and groans.

I have this ritual whenever I come home. Or, as I should probably call it, “home.”

I walk through the whole house and find all the things that are different. Like that game where you look at a picture and then you look at another, nearly identical picture and you have to spot the changes.

One time they had a new machine for juicing citrus fruits. They made fresh juice out of it. Now they make it for me every time.

Another time they had new bookshelves for me to look through. New photos, almost every time, of a little brother and sister who grow up without me now. This time they took apart the kids’ bunk bed. They’re too old for it now; they sleep on their own beds now.

Next time, maybe, they’ll have their own bedrooms.

Things will fall apart and be replaced. New gadgets will appear, charging next to the landline phone. There will be middle school textbooks, high school textbooks, someday. There will be other things, things people need as they grow old, things I can’t think about without literally weeping.

The floor will creak a bit more each time.

Before I left for college, my parents promised me that they’d never clean out my room and turn it into anything else. “This will always be your room, your home,” they said.

They didn’t lie. The only ways they alter my room is to clean it after I leave from my visits, always in a hurry, always leaving behind half my stuff and dragging away other stuff; or when my mom wants to borrow clothes that I left behind. I’ll come home and see her wearing something I’d long forgotten and she says, “Oh, I took this. Hope you don’t mind!” I don’t.

When I come “home” my room is almost the same. Entering it is like reentering the world of my high school self, although I can never really feel or understand that world again. I was so alone. Politically conservative, overly romantic, unable to put a name to the dark moods that often consumed me. The worst was definitely still to come, of course, but I already had a glimpse of what I was in for.

The only source of continuity, really, is writing. Even in high school I was known for that. A very different type of writing, sure, but writing nonetheless. My notebooks and journals fill my old room.

Nearly half a year ago my depression suddenly remitted. Before that, coming home was a treasure. It wasn’t “home” back then; it really was home. I lived for those school breaks. I daydreamed about them in class, at the gym, while I took walks. Nothing felt better than dropping my bags at the bottom of the stairs and taking that first tour of the house, playing the “What’s Different?” game.

After the depression was over, everything changed. Home doesn’t feel like home anymore. It’s merely “home” now.

Now coming “home” feels like being ripped out of my skin and put into another one. Sometimes it triggers a brief depressive episode; the rest of the time it just feels numb. Every object in the house seems to tell me stories about impermanence and decay, even as the house is gleaming and beautiful as ever.

I don’t understand the girl who once lived here. I don’t even want to. But sometimes, what I wouldn’t give to be her for just one more day.

The more this happens the less I want to come “home,” and the more the guilt builds and builds. My mom saw me crying and assumed it was about my finals (as it had been earlier), and I didn’t have the heart to tell her that it’s because I have no home anymore and I don’t belong anywhere and no matter where I go I just can’t come home.

It’s like everything comes at a price. This seems to be the price I pay to be free–mostly–of depression in my day-to-day life. Religious folks might say, “The Lord giveth and the Lord taketh away.” I say, sometimes shit happens. Sometimes this is just how brains work.

And, sometimes, people grow up. Some people will always cherish returning to their childhood homes and swimming through those memories. But I, it seems, just can’t do that. I love this house and the people in it so dearly but it’s not home anymore. That breaks my heart.

Now I know that if I ever want to come home again, I can’t go back. I can only go forward.

The Problem With “Teen Angst” and Why You Should Take Teens’ Mental Health Seriously

[Content note: depression and suicide]

There’s a disturbing and pervasive idea out there that the psychological troubles of teenagers are inconsequential and unworthy of attention because they’re just a part of “teen angst” or “growing up” or whatever.

I’m thinking about this now because last night I ran across this Facebook page. It’s called “No Respect For Suicidal Teens,” and please don’t click on it unless you’re prepared for the hateful victim-blaming that it promotes. (If you can, though, you should go and report it.)

First of all, it’s completely false that teens can’t “really” be depressed and suicidal. Although the age of onset for depression and bipolar disorder is most commonly in the late teens and 20s, many people report that their chronic mood disorder began when they were teens. (Count me among them.) Left untreated, mood disorders often get progressively worse, or they remit on their own but then keep recurring.

Painting all teenage mood problems in a single shade of “teen angst” can prevent teens with diagnosable mood disorders from seeking help, because they either second-guess themselves and conclude that what they’re experiencing is “normal” (read: healthy) or they try to get help but are rebuffed by well-meaning adults who tell them that this is just what adolescence is and that they’ll grow out of it.

And then, of course, they find that it doesn’t get better after adolescence, and sometimes they tragically conclude that they must simply not have “grown up” yet. (Again, count me among them.)

Second, mental issues do not need to have reached clinical levels to be unpleasant, troubling, and inconvenient. Any time you’re unhappy with some aspect of your emotions, moods, thoughts, or behaviors, that’s a good enough reason to seek help from a therapist. Seriously. Either the therapist will help you accept aspects of yourself that you’d been bothered by, or they will help you change those aspects. Whether or not those aspects have a fancy name in the DSM isn’t really relevant.

So a teenager whose emotional experience is characterized by “angst” can benefit from seeking help even if they don’t have a “Real Problem.” All problems are real; the fact that they can vary dramatically in scope and magnitude doesn’t make them any more or less so.

And what if every teenager needs help managing their mental health during adolescence? Doesn’t that mean we’re making mountains out of molehills and inventing problems where none exist?

Nope. Nobody thinks it’s weird that virtually every teenager (who can afford it) goes to a dentist and has their wisdom teeth checked and probably removed. Nobody thinks it’s weird that virtually every female-bodied teenager (who can afford it) starts seeing a gynecologist when they become sexually active. Nobody thinks it’s weird that people of all ages regularly get physicals and get their eyesight and hearing checked.

It is expected that everyone will need (and, hopefully, receive) treatment for some sort of physical ailment over the course of their lives. Yet the idea that even a sizable minority of people will need treatment for a mental problem still gets many people ranting about how we ought to just “snap out of it.”

Are some teenagers actually “over-dramatic” (whatever that even means)? Probably. But it’s hard to tell who’s being over-dramatic and who isn’t, which is why that’s a decision best left to a professional. I was constantly accused of being “over-dramatic” when I was a teenager. Not to put too fine a point on it, but everyone changed their minds very quickly once I became so depressed I could barely function and thought about suicide constantly. Perhaps that could’ve been prevented had I gotten help earlier rather than taking everyone’s analysis of my “over-dramatic” personality to heart.

If a teenager mentions or threatens suicide, take them seriously and help them get treatment. If they turn out to have been “over-dramatic,” a therapist can help them figure out why they threaten suicide hyperbolically and find a way to stop. That’s a therapist’s job, not a friend’s, teacher’s, or parent’s.

The belief that the thoughts and feelings of children and teenagers are not to be taken seriously is widespread and dangerous, and goes far beyond just mental health. It is far better to take someone seriously and get them help when they didn’t really need it than to ignore someone’s call for help and attention when they do need it.