It is hard to talk about mental health. It’s still hard for me, and I have too many years of practice doing it.
These days, I make a conscious effort to be open about my mental health, but I wasn’t always that way. I’ve felt the undercurrent of depression since before I was in high school. When it started to get debilitating, I hid it from myself and those close to me. It took me months to tell my parents and even longer to tell anyone else. How could I describe what I was feeling if I didn’t understand it myself?
The Problem: The ‘Sick-Enough’ Debate
My depression has always tried to convince me that I’m exaggerating. My depression tells me that I’m not sick — instead, it’s some collection of personal flaws of mine. I’m not demotivated or fatigued; I’m lazy. Sensitivity turns into weakness; sadness turns into entitled whining and even more weakness. On my worst days, I still believe my depression. When I try to look for the evidence that I really am sick, not just weak, I struggle to find it.
There’s no objective test for depression. I can’t get a blood or urine test, brain scan, or check for a telling rash. All I have are psychiatrists’ questions and the current Diagnostic and Statistical Manual of Mental Disorders’ (DSM-5) criteria. For my hyper-logical, ‘I-need-real-proof’ mind, those questions aren’t enough. How do I know if I’m being accurate? If I’m exaggerating?
So, if it’s this hard to convince myself that I’m sick, it must be so much harder to convince others, right? I mean, just think of some of the weird stigma around medicating mental illnesses and some of the weird gate-keeping surrounding some diagnoses — it’s mostly around who’s ‘sick enough.’
The Solution: Change the Debate
Well, in the past few years, I’ve come up with a solution: we need to talk about mental health just like physical health. (And, maybe, I just need to stop looking for validation of my diagnosis from others. So what if my coworker doesn’t believe I ‘actually’ have depression? They’re not my doctor, I don’t need their support or belief.)
Here’s a quick test I’ve used on myself (and others) too many times:
First, look at me. Could you tell if I had diabetes? Would you doubt me if I told you I did? … So, why are you doubting me now? My diagnosis was given to me by my doctor, and you are not a doctor.
If I had diabetes, would you tell me to ‘toughen up?’ Would you tell me that I’m weak or exaggerating? That I’m doing it for attention? … So, why are you telling me that now?
I’m telling you that I am struggling and that my mental health is getting in the way of my happiness. Why would you try and convince me not to make a change?
If I had diabetes, would you tell me not to take my insulin? Would you tell me that I don’t want to be ‘dependent’ on it long-term? … Or, would you encourage me to follow my doctor’s advice and do whatever I can to live my best life?
I’ve gone through these questions with myself (and guided some others through them) countless times — it’s almost second nature at this point. And as cheesy as it can be to say these (out loud) to myself, it usually gets me out of the ‘am-I-really-sick?’ spiral. Usually, when I’m back, I’m disappointed in myself and grumpy that it was a question that even crossed my mind.
The Takeaway: Decide for Yourself
Diabetes is the analogy I use all the time for mental illness. I just think it fits so well! Think about it, diabetes exists on a sort of spectrum: some diabetics can manage their diabetes with diet and lifestyle changes; some are dependent on insulin (along with a healthy lifestyle) to lead a normal life. Doesn’t it sound like mental illnesses?
Without my medication, I am a poor version of who I really am. Everything about this loud, obnoxious, sassy woman is subdued, like I’m clouded in the heaviest fog; I don’t see a way out. My fierce independence and ambition disappear and I struggle to get up and do the simplest tasks. I can’t focus enough to learn to cope. I can’t care enough to try. But on my medication, I can see the horizon again. I can start to build skills and put them into practice.
On the flip side, I’ve met people who don’t need medication, they can rely on therapy and coping skills to improve. And that should be okay. Everybody’s illness presents differently and needs a different plan of attack. The game of who is ‘sick enough’ and what kind of treatment is acceptable is a losing one.
So, when you find yourself doubting your illness (or someone else’s), take a step back. Be confident that you know yourself, that it doesn’t matter what you call it, that if it is getting in the way of your life and happiness, you get to change it. So, when your illness yells at you that you don’t deserve help or that you’re not ‘sick enough,’ remember that if it gets in your way at all — you’re allowed to change it.
You wouldn’t let a loved one walk around with an untreated broken arm, so why are you letting yourself walk around with ‘broken’ thoughts?